{
  "hospital_name": "Grove City Methodist",
  "last_updated_on": "2025-01-22",
  "version": "2.2.0",
  "hospital_location": [
    "Grove City Methodist"
  ],
  "hospital_address": [
    "1375 Stringtown Rd, Grove City, OH 43123"
  ],
  "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": "HC Analgesics Non-Opiod; 1 or 2",
      "code_information": [
        {
          "code": "PX-30100115",
          "type": "CDM"
        },
        {
          "code": "80329",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 90,
          "discounted_cash": 58.5,
          "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": 57.78
            },
            {
              "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": 57.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "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": 49.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "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": 90,
              "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": 65.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "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": 49.95
            },
            {
              "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": 57.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 90,
              "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": 90,
              "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": 56.88
            },
            {
              "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": 58.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.59
            },
            {
              "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": 58.59
            },
            {
              "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": 56.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 90,
              "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": 74.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "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": 57.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 57.78
            },
            {
              "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": 24.57
            },
            {
              "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": 65.7
            },
            {
              "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": 76.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 90
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "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": 49.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.78
            },
            {
              "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": 73.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 90,
              "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": 90,
              "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": 76.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "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": 90,
              "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": 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": 57.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 57.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 72.81
            },
            {
              "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": 58.59
            },
            {
              "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": 72.81
            },
            {
              "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": 49.95
            },
            {
              "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": 78.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 74.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.5
            },
            {
              "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": 73.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "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": 56.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 56.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 90,
              "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": 76.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "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": 76.5
            },
            {
              "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": 78.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "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": 90,
              "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": 76.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.78
            },
            {
              "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": 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": 57.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.59
            },
            {
              "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": 73.8
            },
            {
              "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": 79.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 90,
              "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": 90,
              "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": 58.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 74.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "HC Infusion Therapy Initial Up to 1 Hr",
      "code_information": [
        {
          "code": "PX-26000003",
          "type": "CDM"
        },
        {
          "code": "96365",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 666,
          "discounted_cash": 432.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 427.57
            },
            {
              "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": 486.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 566.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 499.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 546.12
            },
            {
              "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": 196.43,
              "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": 190.89,
              "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": 566.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 566.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 486.18
            },
            {
              "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": 188.94,
              "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": 584.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 433.57
            },
            {
              "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": 666,
              "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": 566.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 427.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 486.18
            },
            {
              "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": 666,
              "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": 552.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 420.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 427.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 546.12
            },
            {
              "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": 187.07,
              "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": 369.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 188.94,
              "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": 427.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 566.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 181.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 666
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 433.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 486.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 433.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 566.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 566.1
            },
            {
              "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": 552.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 427.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 427.57
            },
            {
              "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": 666,
              "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": 420.91
            },
            {
              "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": 420.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 538.79
            },
            {
              "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": 187.07,
              "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": 566.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 666,
              "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": 366.3
            },
            {
              "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": 369.63
            },
            {
              "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": 566.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 499.5
            },
            {
              "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": 420.91
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 566.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 552.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 538.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 666,
              "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": 666,
              "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": 586.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 666,
              "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": 499.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 566.1
            },
            {
              "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": 433.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 486.18
            },
            {
              "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": 187.07,
              "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": 187.07,
              "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": 666,
              "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": 369.63
            },
            {
              "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": 566.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 566.1
            },
            {
              "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": 427.57
            },
            {
              "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": 546.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 420.91
            },
            {
              "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": 666,
              "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": 666,
              "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": 427.57
            },
            {
              "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": 546.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 486.18
            },
            {
              "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": 584.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 433.57
            },
            {
              "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": 196.43,
              "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": 420.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 190.89,
              "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": 196.43,
              "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": 427.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 420.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 366.3
            },
            {
              "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": 190.89,
              "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": 666,
              "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": 188.94,
              "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": 366.3
            },
            {
              "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": 188.94,
              "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": 420.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 427.57
            },
            {
              "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": 369.63
            },
            {
              "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": 188.94,
              "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": 427.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 427.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 566.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 666,
              "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": 666,
              "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": 432.9
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrocolloid Drsg Duoderm Cgf 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-CV1876-60",
          "type": "CDM"
        },
        {
          "code": "A6234",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.38,
          "discounted_cash": 8.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.95
            },
            {
              "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": 6.81
            },
            {
              "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": 9.04
            },
            {
              "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": 12.38,
              "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": 12.38,
              "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": 12.38,
              "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": 7.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.52
            },
            {
              "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": 10.89
            },
            {
              "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": 12.38,
              "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": 9.29
            },
            {
              "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": 7.95
            },
            {
              "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": 10.15
            },
            {
              "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": 12.38,
              "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": 10.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.04
            },
            {
              "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": 6.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 12.38,
              "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": 9.04
            },
            {
              "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": 12.38,
              "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": 12.38,
              "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": 12.38,
              "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": 8.06
            },
            {
              "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": 10.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 12.38,
              "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": 10.26
            },
            {
              "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": 7.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 12.38,
              "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": 12.38,
              "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": 10.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.95
            },
            {
              "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": 10.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 10.26
            },
            {
              "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": 12.38,
              "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": 10.52
            },
            {
              "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": 12.38,
              "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": 7.95
            },
            {
              "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": 10.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 6.81
            },
            {
              "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": 7.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 12.38,
              "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": 12.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.82
            },
            {
              "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": 12.38,
              "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": 12.38,
              "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": 12.38,
              "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": 6.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 10.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.04
            },
            {
              "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": 7.95
            },
            {
              "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": 7.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.29
            },
            {
              "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": 10.52
            },
            {
              "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": 12.38,
              "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": 10.86
            },
            {
              "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": 10.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.04
            },
            {
              "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": 12.38,
              "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": 10.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.15
            },
            {
              "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": 12.38,
              "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": 12.38,
              "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": 10.52
            },
            {
              "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": 7.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.15
            },
            {
              "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": 3.38
            },
            {
              "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": 12.38,
              "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": 6.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 7.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.95
            },
            {
              "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": 6.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.82
            },
            {
              "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": 12.38,
              "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": 8.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.06
            },
            {
              "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": 6.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.38,
              "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": 12.38,
              "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": 8.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.81
            },
            {
              "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": 12.38,
              "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": 12.38,
              "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": 10.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 7.95
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tube Tracheostomy",
      "code_information": [
        {
          "code": "PX-27200005",
          "type": "CDM"
        },
        {
          "code": "27200005",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 196,
          "discounted_cash": 127.4,
          "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": 125.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 158.56
            },
            {
              "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": 127.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.8
            },
            {
              "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": 108.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.83
            },
            {
              "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": 125.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 160.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "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": 125.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 160.72
            },
            {
              "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": 125.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 127.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.8
            },
            {
              "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": 196,
              "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": 196
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 127.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 162.48
            },
            {
              "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": 123.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 108.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 143.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 147
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.83
            },
            {
              "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": 160.72
            },
            {
              "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": 123.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 160.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 143.08
            },
            {
              "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": 125.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 147
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.87
            },
            {
              "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": 162.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 143.08
            },
            {
              "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": 196,
              "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": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "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": 196,
              "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": 125.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 127.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 143.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 162.48
            },
            {
              "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": 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": 143.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.87
            },
            {
              "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": 127.4
            },
            {
              "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": 160.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.83
            },
            {
              "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": 158.56
            },
            {
              "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": 160.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 127.2
            },
            {
              "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": 123.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 143.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.87
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "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": 196,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "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": 127.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 127.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 127.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.8
            },
            {
              "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": 172.48
            },
            {
              "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": 107.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 196,
              "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": 108.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 147
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "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": 171.89
            },
            {
              "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": 123.09
            },
            {
              "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": 166.6
            },
            {
              "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": 108.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 166.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 127.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 160.72
            },
            {
              "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": 171.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 123.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 160.72
            },
            {
              "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": 166.6
            }
          ]
        }
      ]
    },
    {
      "description": "Chloraprep 3 Ml Applicator",
      "code_information": [
        {
          "code": "PX-CH-BUR260400",
          "type": "CDM"
        },
        {
          "code": "A4248",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.69,
          "discounted_cash": 2.4,
          "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": 2.37
            },
            {
              "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": 3.69,
              "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": 3.69,
              "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": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.69,
              "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": 3.69,
              "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": 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": 2.37
            },
            {
              "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": 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": 3.03
            },
            {
              "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": 3.69,
              "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": 3.69,
              "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": 3.69,
              "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": 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": 2.77
            },
            {
              "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": 2.33
            },
            {
              "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": 2.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.33
            },
            {
              "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": 3.69,
              "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": 2.03
            },
            {
              "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": 2.37
            },
            {
              "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": 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": 3.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.03
            },
            {
              "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": 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": 1.01
            },
            {
              "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": 3.69,
              "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": 2.05
            },
            {
              "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": 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": 2.4
            },
            {
              "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": 2.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 3.69,
              "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": 3.69,
              "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": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 3.69,
              "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": 3.69
            },
            {
              "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": 3.69,
              "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": 2.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 3.69,
              "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": 2.99
            },
            {
              "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": 3.69,
              "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": 3.69,
              "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": 2.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.69,
              "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": 3.69,
              "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": 2.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.14
            },
            {
              "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": 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": 2.37
            },
            {
              "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": 3.69,
              "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": 3.69,
              "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": 3.14
            },
            {
              "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": 3.69,
              "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": 3.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.69,
              "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": 3.69,
              "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": 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": 3.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 2.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.77
            },
            {
              "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": 3.69,
              "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": 2.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.69,
              "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": 3.69,
              "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": 3.69,
              "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": 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": 2.69
            },
            {
              "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": 3.69,
              "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": 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": 2.37
            },
            {
              "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": 2.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.03
            },
            {
              "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": 3.69,
              "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": 3.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.99
            },
            {
              "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": 3.69,
              "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": 2.69
            },
            {
              "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": 3.69,
              "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": 3.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.69,
              "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": 3.69,
              "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": 2.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.69,
              "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": 2.33
            },
            {
              "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": 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": 2.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.14
            },
            {
              "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": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.69,
              "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": 2.4
            },
            {
              "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": 3.69,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsed Bicarbonate",
      "code_information": [
        {
          "code": "PX-30101227",
          "type": "CDM"
        },
        {
          "code": "82374",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "minimum": 4.19,
          "maximum": 18.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "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": 7.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.88,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "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": 2.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.93,
              "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": 4.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "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": 7.65
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "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": 7.38
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "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": 4.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.93,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "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": 7.65
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.93,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "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": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.19,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.19,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "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": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.12,
              "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": 6.75
            },
            {
              "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": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.88,
              "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": 5.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "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 NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.93,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.19,
              "estimated_amount": 4.19
            },
            {
              "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 FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.19,
              "estimated_amount": 4.19
            },
            {
              "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 [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "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": 7.92
            },
            {
              "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": 7.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "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 HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "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": 4.5
            },
            {
              "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": 4.5
            },
            {
              "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "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": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "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": "MOLINA 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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.88,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.88,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.88,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.04,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.12,
              "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": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.93,
              "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": 7.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.12,
              "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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.88,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.3,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": 50,
              "estimated_amount": 4.5
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.88,
              "estimated_amount": 4.88
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Cvx 5/8 in - 1 11/18 in Sensura",
      "code_information": [
        {
          "code": "PX-CH-CO15696",
          "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 MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "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": 12.77,
              "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": 12.77,
              "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": 9.32
            },
            {
              "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": 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": 12.77,
              "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": 10.33
            },
            {
              "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": 9.32
            },
            {
              "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": 12.77,
              "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": 10.59
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "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": 8.07
            },
            {
              "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 GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "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": 12.77,
              "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": 11.24
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "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 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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE 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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.59
            },
            {
              "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 [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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "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": 10.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "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 [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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.31
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "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": "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": "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"
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "AETNA [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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.77
            },
            {
              "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": 8.07
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "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 TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "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": 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": "AETNA [310]",
              "plan_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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "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": "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC 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": "BUCKEYE COMMUNITY 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": "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": "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 OXFORD [625260]",
              "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 PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.32
            },
            {
              "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": 8.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN 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": "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": "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": "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Non-Adhesive Restore W/ Triact 4 Inx4 In",
      "code_information": [
        {
          "code": "PX-CH-HO509381",
          "type": "CDM"
        },
        {
          "code": "A6209",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6,
          "discounted_cash": 3.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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,
              "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": 4.38
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 5.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "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": 5.28
            },
            {
              "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": 3.79
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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,
              "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": 3.91
            },
            {
              "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": "AETNA [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": "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6,
              "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,
              "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": 3.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 4.38
            },
            {
              "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": 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": 6,
              "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": 3.85
            },
            {
              "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": 3.91
            },
            {
              "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": 5.1
            },
            {
              "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": 3.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "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": "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": "AETNA [310]",
              "plan_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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 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": 6,
              "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": 4.92
            },
            {
              "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": 6,
              "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,
              "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": 4.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6,
              "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": 5.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6,
              "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": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "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": 1.64
            },
            {
              "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": "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": "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,
              "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": 5.1
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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,
              "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,
              "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": 4.38
            },
            {
              "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": 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": 3.79
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE 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,
              "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": 3.91
            },
            {
              "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": 4.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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,
              "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": 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": 4.97
            },
            {
              "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": 5.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 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": 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": 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": 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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6,
              "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": 5.1
            },
            {
              "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": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 3.85
            },
            {
              "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": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 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": 4.92
            },
            {
              "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": 3.33
            },
            {
              "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": 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": 6,
              "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": 5.1
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 6,
              "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,
              "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": 3.33
            },
            {
              "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": "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": "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,
              "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,
              "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": 5.1
            },
            {
              "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": 4.85
            },
            {
              "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": 6,
              "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": 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": 4.92
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Wipe Sting Free Sensi Care",
      "code_information": [
        {
          "code": "PX-CH-CV4135-01",
          "type": "CDM"
        },
        {
          "code": "A5120",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.04,
          "discounted_cash": 0.68,
          "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": 0.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "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": 1.04,
              "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": 1.04
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "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": 0.85
            },
            {
              "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": 0.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.86
            },
            {
              "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/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": "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.04,
              "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": 0.66
            },
            {
              "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": "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": 1.04,
              "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": 1.04,
              "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": 1.04,
              "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": 0.67
            },
            {
              "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": 0.85
            },
            {
              "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": 0.67
            },
            {
              "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.67
            },
            {
              "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": 0.68
            },
            {
              "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": 1.04,
              "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": 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": 0.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "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": 1.04,
              "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": 0.88
            },
            {
              "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": "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": "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 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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.04,
              "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": 0.67
            },
            {
              "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.04,
              "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": 0.88
            },
            {
              "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": "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": "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.04,
              "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": 1.04,
              "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": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "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": "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": "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": "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 [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "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": "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.04,
              "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": 0.57
            },
            {
              "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": 0.67
            },
            {
              "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": 0.57
            },
            {
              "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": 1.04,
              "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": 1.04,
              "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": 0.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "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": 0.28
            },
            {
              "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": 1.04,
              "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": 1.04,
              "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": 1.04,
              "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": 0.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.86
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.92
            },
            {
              "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": 0.67
            },
            {
              "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": 0.76
            },
            {
              "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": 0.91
            },
            {
              "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": 0.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.78
            },
            {
              "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": 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": 0.66
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.04,
              "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": 1.04,
              "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": 0.68
            },
            {
              "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": "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": "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 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 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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "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": 0.88
            },
            {
              "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": 1.04,
              "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": 0.91
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.04,
              "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": 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": 0.58
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "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": "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            }
          ]
        }
      ]
    },
    {
      "description": "Gloves Latex Powder-Free X-Large",
      "code_information": [
        {
          "code": "PX-CH-M9PF4004",
          "type": "CDM"
        },
        {
          "code": "A4927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.1,
          "discounted_cash": 0.06,
          "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": 0.06
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "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": 0.03
            },
            {
              "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": "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": "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": "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": "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": "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": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "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": "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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "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": 0.1,
              "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": 0.1,
              "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": 0.07
            },
            {
              "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "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": 0.09
            },
            {
              "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": 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": "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 NAVIGATE [625280]",
              "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": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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 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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "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": 0.1,
              "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": 0.1,
              "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": 0.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "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": 0.1,
              "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": 0.06
            },
            {
              "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": "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": "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": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": "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": "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": "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": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.1,
              "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": 0.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "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": 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": "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 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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.09
            },
            {
              "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": 0.1,
              "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": 0.08
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.08
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.1,
              "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": 0.06
            },
            {
              "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": 0.1,
              "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": 0.06
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "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": "BUCKEYE COMMUNITY 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": "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": "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": "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": "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": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": "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": "AETNA [310]",
              "plan_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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "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": "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": "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": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "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": 0.1,
              "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": 0.1,
              "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": 0.1,
              "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": "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": "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": "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 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.06
            },
            {
              "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": 0.08
            },
            {
              "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": "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": "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
            }
          ]
        }
      ]
    },
    {
      "description": "Brca1 and 2 Seq and Full Dup/Del Sendout",
      "code_information": [
        {
          "code": "PX-30101230",
          "type": "CDM"
        },
        {
          "code": "81162",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5670,
          "discounted_cash": 3685.5,
          "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": 3640.14
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1843.13,
              "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": 1824.88,
              "estimated_amount": 1824.88
            },
            {
              "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": 3685.5
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1843.13,
              "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": 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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "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": 4819.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "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": 3583.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "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": 4649.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "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": 4139.1
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1843.13,
              "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": 4139.1
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5670
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1824.88,
              "estimated_amount": 1824.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "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": 4649.4
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1824.88,
              "estimated_amount": 1824.88
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1824.88,
              "estimated_amount": 1824.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1843.13,
              "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": 3583.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "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": "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 OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "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": "AETNA [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": "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": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1824.88,
              "estimated_amount": 1824.88
            },
            {
              "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": 3146.85
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1916.12,
              "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": 3691.17
            },
            {
              "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": 4649.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4700.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1916.12,
              "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": 3640.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1824.88,
              "estimated_amount": 1824.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1843.13,
              "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": 3640.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "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": 4989.6
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 1824.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 1916.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "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": 3146.85
            },
            {
              "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": 4972.59
            },
            {
              "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": "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": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "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": 3640.14
            },
            {
              "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": 3691.17
            },
            {
              "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": 3583.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "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": 1547.91
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "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": 3146.85
            },
            {
              "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": 4972.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "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": 1241.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6843.3,
              "estimated_amount": 6843.3
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1824.88,
              "estimated_amount": 1824.88
            },
            {
              "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": 4587.03
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4700.43
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            }
          ],
          "minimum": 1824.88,
          "maximum": 6843.3
        }
      ]
    },
    {
      "description": "Inner Cannula Disposable Shiley Size 8",
      "code_information": [
        {
          "code": "PX-CH-2M8DIC",
          "type": "CDM"
        },
        {
          "code": "A4623",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.49,
          "discounted_cash": 4.22,
          "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": 4.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 5.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 5.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 3.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.49
            },
            {
              "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": 4.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.22
            },
            {
              "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": 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": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 5.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 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": 3.57
            },
            {
              "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": 6.49,
              "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": 5.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.52
            },
            {
              "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": 6.49,
              "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": 5.71
            },
            {
              "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": 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": 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": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 6.49,
              "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": 4.17
            },
            {
              "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": 4.17
            },
            {
              "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": 4.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 6.49,
              "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": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 5.52
            },
            {
              "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": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 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": 5.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.49,
              "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": 4.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.87
            },
            {
              "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": 4.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.74
            },
            {
              "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": 1.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.17
            },
            {
              "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": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 6.49,
              "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": 6.49,
              "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": 5.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 6.49,
              "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": 5.38
            },
            {
              "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": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 4.74
            },
            {
              "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": 4.17
            },
            {
              "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": 5.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.32
            },
            {
              "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": 5.52
            },
            {
              "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": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.74
            },
            {
              "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": 4.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.49,
              "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": 6.49,
              "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": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.17
            },
            {
              "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": 6.49,
              "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": 3.6
            }
          ]
        }
      ]
    },
    {
      "description": "Island Composite Drsg Adhesive Medipore 3 1/2 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-3M3566",
          "type": "CDM"
        },
        {
          "code": "A6219",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.97,
          "discounted_cash": 0.63,
          "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": 0.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.53
            },
            {
              "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": 0.97,
              "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": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.97,
              "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": 0.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.78
            },
            {
              "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": 0.62
            },
            {
              "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": 0.85
            },
            {
              "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": 0.97,
              "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": 0.82
            },
            {
              "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": 0.97,
              "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": 0.54
            },
            {
              "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": 0.97,
              "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": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.8
            },
            {
              "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": 0.63
            },
            {
              "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": 0.97,
              "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": 0.97,
              "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": 0.82
            },
            {
              "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": 0.97,
              "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": 0.73
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.97,
              "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": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.71
            },
            {
              "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": 0.97,
              "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": 0.61
            },
            {
              "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": 0.61
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.97,
              "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": 0.53
            },
            {
              "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": 0.97,
              "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": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "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": 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": 0.97,
              "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": 0.97,
              "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": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "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": 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": 0.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.97,
              "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": 0.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.62
            },
            {
              "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": 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": 0.53
            },
            {
              "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": 0.97,
              "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": 0.97,
              "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": 0.97,
              "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": 0.97,
              "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": 0.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.97,
              "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": 0.53
            },
            {
              "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": 0.62
            },
            {
              "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": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "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": 0.82
            },
            {
              "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": 0.97,
              "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": 0.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.71
            },
            {
              "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": 0.97,
              "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": 0.61
            },
            {
              "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": 0.97,
              "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": 0.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.71
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.97,
              "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": 0.97,
              "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": 0.53
            },
            {
              "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": 0.97,
              "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": 0.8
            },
            {
              "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": 0.97,
              "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": 0.62
            },
            {
              "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": 0.26
            }
          ]
        }
      ]
    },
    {
      "description": "Deodorizer M-9 Drop 8 Oz",
      "code_information": [
        {
          "code": "PX-CH-HO7717",
          "type": "CDM"
        },
        {
          "code": "A4394",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17.24,
          "discounted_cash": 11.21,
          "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": 11.07
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 17.24,
              "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": 17.24,
              "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": 11.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 14.65
            },
            {
              "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": 9.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.93
            },
            {
              "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": 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": 17.24,
              "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": 9.57
            },
            {
              "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": 14.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.07
            },
            {
              "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": 11.22
            },
            {
              "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": 14.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 9.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 9.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.48
            },
            {
              "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": 13.95
            },
            {
              "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": 4.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 14.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.07
            },
            {
              "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": 11.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.93
            },
            {
              "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": 11.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.9
            },
            {
              "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": 17.24,
              "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": 11.07
            },
            {
              "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": 17.24,
              "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": 17.24,
              "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": 14.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.65
            },
            {
              "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": 14.14
            },
            {
              "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": 14.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.14
            },
            {
              "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": 10.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 17.24,
              "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": 9.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.48
            },
            {
              "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": 10.9
            },
            {
              "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": 9.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 17.24,
              "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": 11.21
            },
            {
              "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": 11.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.65
            },
            {
              "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": 15.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 14.65
            },
            {
              "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": 17.24,
              "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": 17.24,
              "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": 14.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 10.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.9
            },
            {
              "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": 11.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17.24
            },
            {
              "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": 10.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.59
            },
            {
              "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": 15.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 12.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.65
            },
            {
              "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": 14.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.14
            },
            {
              "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": 9.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "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": 9.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Impregnated Vaseline 3 in X 9 In",
      "code_information": [
        {
          "code": "PX-CH-SH413605",
          "type": "CDM"
        },
        {
          "code": "A6223",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.12,
          "discounted_cash": 0.73,
          "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": 0.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 1.12,
              "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": 1.12,
              "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": 0.95
            },
            {
              "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": 0.72
            },
            {
              "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": 0.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.92
            },
            {
              "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": 1.12,
              "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": 1.12,
              "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": 0.62
            },
            {
              "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": 1.12,
              "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": 0.95
            },
            {
              "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": 0.72
            },
            {
              "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": 0.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 1.12,
              "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": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 0.95
            },
            {
              "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": "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.12,
              "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": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "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": 0.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 0.98
            },
            {
              "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": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 1.12,
              "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": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.73
            },
            {
              "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": 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": 0.95
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 0.72
            },
            {
              "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": 0.92
            },
            {
              "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": 0.92
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.12,
              "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": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 0.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.12
            },
            {
              "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": 1.12,
              "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": 1.12,
              "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": 1.12,
              "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": 0.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.93
            },
            {
              "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": 0.71
            },
            {
              "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": 0.98
            },
            {
              "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": 0.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.12,
              "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": 1.12,
              "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": 1.12,
              "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": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 0.62
            },
            {
              "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": 0.62
            },
            {
              "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": 0.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.84
            },
            {
              "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": 1.12,
              "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": 0.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 1.12,
              "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": 0.62
            },
            {
              "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": 1.12,
              "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": 0.82
            },
            {
              "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": 1.12,
              "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": 0.95
            },
            {
              "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": 1.12,
              "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": 1.12,
              "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": 0.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.12,
              "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": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 0.62
            },
            {
              "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": 0.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 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": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.12,
              "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": 0.95
            },
            {
              "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": 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": 0.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.12,
              "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": 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.82
            },
            {
              "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": 0.72
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.84
            },
            {
              "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": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.95
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.93
            },
            {
              "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": 1.12,
              "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": 1.12,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Central Line Dressing Tray W/2% Chg",
      "code_information": [
        {
          "code": "PX-CH-AC262834",
          "type": "CDM"
        },
        {
          "code": "A4221",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.91,
          "discounted_cash": 5.14,
          "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": 5.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "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 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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.91
            },
            {
              "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": "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": "AETNA [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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "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": 6.94
            },
            {
              "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": "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": "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": "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": "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.91,
              "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": 6.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "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": 6.49
            },
            {
              "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 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 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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "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": 6.94
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "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": "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 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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "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": 5.14
            },
            {
              "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "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 PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.77
            },
            {
              "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": "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": "AETNA [310]",
              "plan_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": "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "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": 6.49
            },
            {
              "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": 7.91,
              "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": 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": 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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "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": 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": 6.96
            },
            {
              "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 OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 6.49
            },
            {
              "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": 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": 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": "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": "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": "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": "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": "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": "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": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.91,
              "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": 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": 5
            },
            {
              "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": "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "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": 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": 6.72
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 4.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "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": 7.91,
              "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": 7.91,
              "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": 6.56
            },
            {
              "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": 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": 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": 2.16
            },
            {
              "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": 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": 7.91,
              "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": 5.93
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 11.05,
          "discounted_cash": 7.18,
          "payers_information": [
            {
              "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "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": 7.19
            },
            {
              "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": 9.16
            },
            {
              "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": 9.06
            },
            {
              "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": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "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": "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": "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": "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": "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 GEHA [625285]",
              "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/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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "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": "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": "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": "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": "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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.05,
              "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": 9.06
            },
            {
              "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": 6.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.16
            },
            {
              "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": 11.05,
              "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": 9.16
            },
            {
              "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": 7.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "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": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.05,
              "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": 8.07
            },
            {
              "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": 9.06
            },
            {
              "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": "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": "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": "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 OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "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": "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": "HUMANA [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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "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": 9.39
            },
            {
              "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": 6.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.13
            },
            {
              "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": "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
            },
            {
              "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.19
            },
            {
              "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": 3.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 9.06
            },
            {
              "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "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* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.08
            },
            {
              "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 7.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.07
            },
            {
              "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
            }
          ]
        }
      ]
    },
    {
      "description": "Tubing Extension 18 in Latex Free",
      "code_information": [
        {
          "code": "PX-CH-BA4A4194",
          "type": "CDM"
        },
        {
          "code": "A4331",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.3,
          "discounted_cash": 2.14,
          "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": 2.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 2.15
            },
            {
              "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": 3.3,
              "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": 1.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 2.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 2.12
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 2.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.41
            },
            {
              "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": 2.89
            },
            {
              "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": 2.81
            },
            {
              "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": 2.89
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 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": 2.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 3.3,
              "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": 0.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.41
            },
            {
              "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": 2.12
            },
            {
              "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": 2.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 2.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 3.3,
              "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": 2.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 2.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 1.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 2.81
            },
            {
              "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": 1.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.3
            },
            {
              "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": 1.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "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": 3.3,
              "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": 2.15
            },
            {
              "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": 2.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 2.12
            },
            {
              "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": 2.71
            },
            {
              "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": 2.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "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": 3.3,
              "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": 2.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.41
            },
            {
              "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": 2.09
            },
            {
              "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": 2.81
            },
            {
              "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": 2.12
            },
            {
              "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": 1.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.41
            },
            {
              "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": 2.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.3,
              "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": 1.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.3,
              "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": 3.3,
              "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": 2.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.12
            },
            {
              "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": 2.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 2.83,
          "discounted_cash": 1.84,
          "payers_information": [
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.29
            },
            {
              "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": 2.83,
              "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": 1.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.83,
              "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": 1.82
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.41
            },
            {
              "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": 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": 2.48
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 2.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.79
            },
            {
              "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": 2.83,
              "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": 2.49
            },
            {
              "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": 1.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.32
            },
            {
              "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": 2.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.35
            },
            {
              "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": 1.79
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.83,
              "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": 1.84
            },
            {
              "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": 1.82
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 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": 2.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.57
            },
            {
              "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": 2.83,
              "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": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.41
            },
            {
              "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": 2.83,
              "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": 1.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.83,
              "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": 1.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.79
            },
            {
              "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": 2.83,
              "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": 2.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.12
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.83,
              "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": 2.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 1.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.32
            },
            {
              "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": 1.82
            },
            {
              "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": 1.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.84
            },
            {
              "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": 2.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "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": 2.07
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.07
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "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": 2.83,
              "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": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.83,
              "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": 2.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.79
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 4.34,
          "discounted_cash": 2.82,
          "payers_information": [
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 3.56
            },
            {
              "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": 4.34,
              "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": 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": 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": 2.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 3.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 2.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.79
            },
            {
              "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": 2.83
            },
            {
              "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": 3.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 3.17
            },
            {
              "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": 3.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.17
            },
            {
              "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": 2.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 4.34,
              "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": 2.79
            },
            {
              "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": 3.56
            },
            {
              "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": 4.34,
              "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": 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": 3.56
            },
            {
              "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": 4.34,
              "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": 4.34,
              "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": 4.34,
              "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": 2.41
            },
            {
              "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": 3.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.56
            },
            {
              "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": 4.34,
              "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": 2.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 4.34,
              "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": 3.81
            },
            {
              "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": 4.34,
              "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": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.74
            },
            {
              "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": 2.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.17
            },
            {
              "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": 4.34,
              "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": 2.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 3.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.69
            },
            {
              "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": 4.34,
              "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": 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": 3.17
            },
            {
              "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": 4.34,
              "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": 2.79
            },
            {
              "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": 2.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 4.34,
              "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": 3.69
            },
            {
              "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": 4.34,
              "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": 4.34,
              "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": 3.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.34,
              "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": 1.18
            },
            {
              "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": 2.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "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": 4.34,
              "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": 3.56
            },
            {
              "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": 4.34,
              "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": 4.34,
              "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": 4.34,
              "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": 4.34,
              "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": 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": 2.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.34,
              "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": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.34,
              "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": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.83
            },
            {
              "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": 4.34,
              "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": 4.34,
              "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": 4.34,
              "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": 4.34,
              "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": 3.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.69
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Rings 4 in Adapt",
      "code_information": [
        {
          "code": "PX-CH-HO7806",
          "type": "CDM"
        },
        {
          "code": "A4385",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.35,
          "discounted_cash": 2.83,
          "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": 2.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.7
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 2.83
            },
            {
              "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": 4.35,
              "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": 2.41
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.7
            },
            {
              "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": 3.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.18
            },
            {
              "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": 4.35,
              "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": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.35,
              "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": 3.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.39
            },
            {
              "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": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.83
            },
            {
              "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": 3.18
            },
            {
              "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": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 2.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.52
            },
            {
              "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": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 3.81
            },
            {
              "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": 2.75
            },
            {
              "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": 3.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.35,
              "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": 4.35,
              "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": 1.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 3.52
            },
            {
              "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": 3.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.35,
              "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": 2.75
            },
            {
              "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": 4.35,
              "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": 4.35,
              "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": 2.39
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 2.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.35,
              "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": 4.35,
              "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": 3.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.83
            },
            {
              "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": 3.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.18
            },
            {
              "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": 4.35,
              "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": 2.79
            },
            {
              "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": 2.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.35,
              "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": 4.35,
              "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": 3.7
            },
            {
              "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": 2.79
            },
            {
              "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": 4.35,
              "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": 4.35,
              "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": 3.7
            },
            {
              "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": 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": 3.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 3.57
            },
            {
              "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": 4.35,
              "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": 3.7
            },
            {
              "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": 4.35,
              "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": 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": 3.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.57
            },
            {
              "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": 4.35,
              "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": 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": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.39
            },
            {
              "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": 2.79
            },
            {
              "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": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 4.35,
              "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": 2.79
            },
            {
              "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": 3.7
            },
            {
              "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": 2.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.18
            }
          ]
        }
      ]
    },
    {
      "description": "Walking Boot Non-Pneum Fit to Pt W/Adj",
      "code_information": [
        {
          "code": "PX-27400020",
          "type": "CDM"
        },
        {
          "code": "L4386",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 512,
          "discounted_cash": 332.8,
          "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": 328.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 188.43,
              "additional_payer_notes": "DMEPOS 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": 512,
              "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": 328.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 512,
              "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": 333.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 188.43,
              "additional_payer_notes": "DMEPOS 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": 328.7
            },
            {
              "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": 328.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 186.56,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 284.16
            },
            {
              "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": 424.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 328.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 373.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 188.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 186.56,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 328.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 333.31
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 186.56,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 333.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 512,
              "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": 512,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 186.56,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 328.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 186.56,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 373.76
            },
            {
              "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": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 512,
              "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": 512,
              "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": 186.56,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 333.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.89,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 188.43,
              "additional_payer_notes": "DMEPOS 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": 512,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 188.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 328.7
            },
            {
              "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": 414.21
            },
            {
              "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": 328.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 328.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 414.21
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.89,
              "additional_payer_notes": "DMEPOS 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": 424.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 424.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 328.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 373.76
            },
            {
              "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": 373.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "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": 333.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 373.76
            },
            {
              "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": 284.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 186.56,
              "estimated_amount": 186.56
            },
            {
              "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": 284.16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 186.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.89,
              "additional_payer_notes": "DMEPOS 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": 284.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 186.56,
              "estimated_amount": 186.56
            },
            {
              "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": 512,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 186.56,
              "estimated_amount": 186.56
            },
            {
              "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": 328.7
            }
          ],
          "minimum": 186.56,
          "maximum": 186.56
        }
      ]
    },
    {
      "description": "Splint Finger Pip Dip Spring Pf Off the Shelf",
      "code_information": [
        {
          "code": "PX-27400023",
          "type": "CDM"
        },
        {
          "code": "L3925",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 45,
          "discounted_cash": 29.25,
          "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": 28.85
            },
            {
              "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": 28.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.34,
              "estimated_amount": 70.34
            },
            {
              "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": 38.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "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": 45,
              "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": 27.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 29.48
            },
            {
              "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": 29.3
            },
            {
              "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": 36.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.34,
              "estimated_amount": 70.34
            },
            {
              "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": 39.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 28.76
            },
            {
              "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": 45,
              "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": 39.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "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": 45,
              "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": 33.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 71.04,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.34,
              "estimated_amount": 70.34
            },
            {
              "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": 32.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 73.86,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 71.04,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 29.48
            },
            {
              "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": 36.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 71.04,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.34,
              "estimated_amount": 70.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 28.85
            },
            {
              "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": 12.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 73.86,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "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": 24.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "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": 29.48
            },
            {
              "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": 29.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 28.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.34,
              "estimated_amount": 70.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.3
            },
            {
              "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": 28.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.3
            },
            {
              "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": 36.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 29.48
            },
            {
              "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": 39.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "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": 36.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 71.04,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.34,
              "estimated_amount": 70.34
            },
            {
              "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": 24.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 71.04,
              "additional_payer_notes": "DMEPOS 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": 37.31
            },
            {
              "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": 24.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 70.34,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 73.86,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "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": 29.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 28.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 28.76
            },
            {
              "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": 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": 24.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "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": 45,
              "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": 38.25
            },
            {
              "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": 29.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.75
            },
            {
              "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": 28.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.34,
              "estimated_amount": 70.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "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": 27.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 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": 33.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 28.85
            },
            {
              "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": 28.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "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": 24.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 27.45
            },
            {
              "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": 38.25
            },
            {
              "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": 29.25
            }
          ],
          "minimum": 70.34,
          "maximum": 70.34
        }
      ]
    },
    {
      "description": "Splint Finger Pip Dip Stat Rng Pf Off the Shelf",
      "code_information": [
        {
          "code": "PX-27400024",
          "type": "CDM"
        },
        {
          "code": "L3927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20,
          "discounted_cash": 13,
          "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": 12.82
            },
            {
              "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": 20,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.35,
              "additional_payer_notes": "DMEPOS 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
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "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": 14.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.85,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 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": 17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 16.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.85,
              "additional_payer_notes": "DMEPOS 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": 17.54
            },
            {
              "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": 13.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 12.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 17.54
            },
            {
              "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": 12.2
            },
            {
              "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": 13.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 13.1
            },
            {
              "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": 13.1
            },
            {
              "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": 20,
              "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": 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": 12.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.48,
              "estimated_amount": 37.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.48,
              "estimated_amount": 37.48
            },
            {
              "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": 20,
              "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": 12.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.85,
              "additional_payer_notes": "DMEPOS 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": 14.6
            },
            {
              "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": 13.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 12.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.02
            },
            {
              "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": 16.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 13.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 20
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 13.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 12.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.1
            },
            {
              "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": 11.1
            },
            {
              "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": 16.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.48,
              "estimated_amount": 37.48
            },
            {
              "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": 64.1,
              "estimated_amount": 12.82
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.48,
              "estimated_amount": 37.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.48,
              "estimated_amount": 37.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.85,
              "additional_payer_notes": "DMEPOS 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
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20,
              "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": 20,
              "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": 20,
              "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": 11.1
            },
            {
              "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": 16.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.85,
              "additional_payer_notes": "DMEPOS 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
            },
            {
              "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": 12.82
            },
            {
              "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": 5.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.48,
              "estimated_amount": 37.48
            },
            {
              "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": 17.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 12.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "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": 12.82
            },
            {
              "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": 12.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.02
            },
            {
              "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": 16.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 13.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "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": 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": 16.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 12.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 14.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.48,
              "estimated_amount": 37.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.35,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 13.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 12.78
            },
            {
              "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": 13.02
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 37.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.35,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            }
          ],
          "minimum": 37.48,
          "maximum": 37.48
        }
      ]
    },
    {
      "description": "Collar Soft Off the Shelf",
      "code_information": [
        {
          "code": "PX-27400033",
          "type": "CDM"
        },
        {
          "code": "L0120",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12,
          "discounted_cash": 7.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "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": 10.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "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": 12,
              "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": 6.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "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": "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": "UHC 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 9.84
            },
            {
              "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": 12,
              "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": 8.76
            },
            {
              "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": 10.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 9.71
            },
            {
              "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": 9.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "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": 10.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 7.69
            },
            {
              "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": 7.69
            },
            {
              "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": 7.69
            },
            {
              "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": 12,
              "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": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 7.67
            },
            {
              "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": 6.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 7.69
            },
            {
              "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": 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": 9.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 7.69
            },
            {
              "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": 7.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.6
            },
            {
              "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": 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": 9.95
            },
            {
              "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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS 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": 9.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "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": 10.2
            },
            {
              "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": 10.2
            },
            {
              "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": 6.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "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": 64.1,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.81
            },
            {
              "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": 3.28
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.66
            },
            {
              "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": 7.8
            },
            {
              "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": 7.69
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.2
            },
            {
              "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": "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": 7.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.6
            },
            {
              "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": 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": 12,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 9.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "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": 10.56
            },
            {
              "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": 7.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            }
          ],
          "minimum": 31.12,
          "maximum": 31.12
        }
      ]
    },
    {
      "description": "Foam Drsg Non-Adhesive Tielle 4 1/4 X 4 1/4 Max Hydropolymer",
      "code_information": [
        {
          "code": "PX-CH-MTP701",
          "type": "CDM"
        },
        {
          "code": "A6209",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.32,
          "discounted_cash": 6.06,
          "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": 5.98
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.32,
              "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": 9.32,
              "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": 7.92
            },
            {
              "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": 7.64
            },
            {
              "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": 9.32,
              "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": 5.17
            },
            {
              "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": 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": 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": 9.32,
              "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": 9.32,
              "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": 9.32,
              "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": 5.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.92
            },
            {
              "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": 9.32,
              "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": 9.32,
              "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": 7.73
            },
            {
              "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": 7.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.89
            },
            {
              "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": 2.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.32,
              "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": 7.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.98
            },
            {
              "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": 9.32,
              "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": 6.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.32,
              "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": 9.32,
              "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": 5.98
            },
            {
              "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": 7.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.07
            },
            {
              "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": 6.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.8
            },
            {
              "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": 9.32,
              "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": 9.32,
              "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": 7.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.32,
              "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": 9.32,
              "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": 5.13
            },
            {
              "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": 5.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.32,
              "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": 5.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.64
            },
            {
              "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": 9.32,
              "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": 8.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.13
            },
            {
              "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": 9.32,
              "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": 7.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.13
            },
            {
              "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": 5.17
            },
            {
              "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": 7.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.32,
              "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": 9.32,
              "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": 6.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.32,
              "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": 9.32,
              "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": 9.32,
              "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": 9.32,
              "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": 7.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.98
            },
            {
              "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": 6.07
            },
            {
              "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": 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": 7.64
            },
            {
              "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": 8.17
            },
            {
              "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": 9.32,
              "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": 9.32,
              "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": 5.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 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": 5.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 5.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.32,
              "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": 9.32,
              "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": 7.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.54
            },
            {
              "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": 7.64
            },
            {
              "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": 9.32,
              "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": 9.32,
              "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": 9.32,
              "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": 9.32,
              "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": 5.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.98
            },
            {
              "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": 5.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 6.8
            },
            {
              "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": 9.32,
              "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": 9.32,
              "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": 5.89
            },
            {
              "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": 5.89
            },
            {
              "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": 9.32,
              "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": 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": 5.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.89
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pretreatment With Enzymes Each",
      "code_information": [
        {
          "code": "PX-30000019",
          "type": "CDM"
        },
        {
          "code": "86971",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 343,
          "discounted_cash": 222.95,
          "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": 220.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 281.26
            },
            {
              "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": 216.78
            },
            {
              "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": 300.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 190.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 188.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 188.65
            },
            {
              "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": 329.41,
              "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": 291.55
            },
            {
              "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": 316.86,
              "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": 216.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 220.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 220.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 216.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 220.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 188.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 250.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 284.35
            },
            {
              "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": 220.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 220.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 223.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 284.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 216.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 223.29
            },
            {
              "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": 223.29
            },
            {
              "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": 281.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 220.21
            },
            {
              "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": 277.49
            },
            {
              "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": 281.26
            },
            {
              "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": 313.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "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": 220.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 281.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 284.35
            },
            {
              "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": 291.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 329.41,
              "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": 188.65
            },
            {
              "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": 313.72,
              "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": 291.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 190.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 257.25
            },
            {
              "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": 313.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 257.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 250.39
            },
            {
              "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": 316.86,
              "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": 313.72,
              "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": 291.55
            },
            {
              "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": 190.37
            },
            {
              "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": 190.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 277.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 250.39
            },
            {
              "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": 320.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.47,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "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": 329.41,
              "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": 300.81
            },
            {
              "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": 301.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 223.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 281.26
            },
            {
              "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": 316.86,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 188.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 250.39
            },
            {
              "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": 93.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 250.39
            },
            {
              "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": 220.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 281.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.47,
              "estimated_amount": 17.47
            },
            {
              "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": 216.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "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": 223.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 220.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 216.78
            },
            {
              "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": 188.65
            },
            {
              "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": 250.39
            },
            {
              "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": 316.86,
              "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": 188.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 216.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 291.55
            },
            {
              "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": 220.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 281.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 216.78
            },
            {
              "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": 320.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 222.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 343
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 281.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 257.25
            },
            {
              "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": 316.86,
              "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": 220.21
            },
            {
              "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": 320.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.47,
              "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": 291.55
            }
          ],
          "minimum": 17.47,
          "maximum": 1215.41
        }
      ]
    },
    {
      "description": "HC Fat Stain Urine",
      "code_information": [
        {
          "code": "PX-30000037",
          "type": "CDM"
        },
        {
          "code": "89125",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 58,
          "discounted_cash": 37.7,
          "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": 37.24
            },
            {
              "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": 37.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "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": 37.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.34
            },
            {
              "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": 31.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.56
            },
            {
              "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": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 47.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "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": 36.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.24
            },
            {
              "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": 47.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "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": 37.7
            },
            {
              "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": 58,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "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": 32.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.24
            },
            {
              "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": 36.66
            },
            {
              "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": 37.24
            },
            {
              "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": 36.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 32.19
            },
            {
              "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": 37.76
            },
            {
              "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": 15.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "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": 37.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.9
            },
            {
              "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": 48.08
            },
            {
              "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": 49.3
            },
            {
              "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": 50.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 46.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "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": 58,
              "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": 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": 36.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "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": 37.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.9
            },
            {
              "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": 32.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 48.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 48.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.3,
              "estimated_amount": 6.3
            },
            {
              "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": 46.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.56
            },
            {
              "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": 50.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.24
            },
            {
              "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": 47.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.3,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "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": 58,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.9
            },
            {
              "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": 42.34
            },
            {
              "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": 37.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 36.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.05,
              "estimated_amount": 22.05
            },
            {
              "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": 51.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.5
            }
          ],
          "minimum": 6.3,
          "maximum": 22.05
        }
      ]
    },
    {
      "description": "HC Theophylline",
      "code_information": [
        {
          "code": "PX-30100041",
          "type": "CDM"
        },
        {
          "code": "80198",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 108,
          "discounted_cash": 70.2,
          "minimum": 12.12,
          "maximum": 53.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "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": 70.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "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": 91.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.14,
              "estimated_amount": 14.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.28,
              "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": 91.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 108
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 91.8
            },
            {
              "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": 48.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "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": 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": 88.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 88.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.12,
              "estimated_amount": 12.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.14,
              "estimated_amount": 14.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 88.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.85,
              "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": 14.14,
              "estimated_amount": 14.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.68,
              "estimated_amount": 20.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "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": 27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "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": 88.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.14,
              "estimated_amount": 14.14
            },
            {
              "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": 48.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "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": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.12,
              "estimated_amount": 12.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.68,
              "estimated_amount": 20.68
            },
            {
              "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": 78.84
            },
            {
              "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": 59.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.12,
              "estimated_amount": 12.12
            },
            {
              "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": 54
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.14,
              "estimated_amount": 14.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "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": 88.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.68,
              "estimated_amount": 20.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.14,
              "estimated_amount": 14.14
            },
            {
              "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": 95.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.14,
              "estimated_amount": 14.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.12,
              "estimated_amount": 12.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.03,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 14.14,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.28,
              "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": 88.56
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe Only 3cc Luer Lock",
      "code_information": [
        {
          "code": "PX-CH-TESS03L",
          "type": "CDM"
        },
        {
          "code": "A4657",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.12,
          "discounted_cash": 0.08,
          "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": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.1
            },
            {
              "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": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.09
            },
            {
              "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": 0.12,
              "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": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.08
            },
            {
              "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": 0.12,
              "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": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.09
            },
            {
              "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": 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": 0.08
            },
            {
              "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": 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": 0.11
            },
            {
              "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": 0.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.1
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.08
            },
            {
              "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": 0.12,
              "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": 0.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.1
            },
            {
              "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": 0.12,
              "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": 0.12,
              "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": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.12,
              "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": 0.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.12,
              "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": 0.12,
              "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": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.12,
              "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": 0.07
            },
            {
              "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": 0.08
            },
            {
              "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": 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": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.08
            },
            {
              "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": 0.12,
              "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": 0.07
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.12,
              "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": 0.08
            },
            {
              "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": 0.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.07
            },
            {
              "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": 0.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.1
            },
            {
              "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": 0.12,
              "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": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.12,
              "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": 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": 0.12,
              "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": 0.12,
              "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": 0.12,
              "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": 0.12,
              "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": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.12,
              "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": 0.1
            },
            {
              "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": 0.12,
              "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": 0.08
            },
            {
              "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": 0.12,
              "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": 0.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.12,
              "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": 0.12,
              "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": 0.12,
              "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": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.1
            },
            {
              "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": 0.12,
              "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": 0.1
            },
            {
              "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": 0.08
            },
            {
              "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": 0.1
            },
            {
              "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": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.12,
              "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": 0.12,
              "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": 0.1
            },
            {
              "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": 0.12,
              "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": 0.11
            }
          ]
        }
      ]
    },
    {
      "description": "Shoe Covers Non Skid Xlarge 1 Roll=10 Each",
      "code_information": [
        {
          "code": "PX-CH-DY2134",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.13,
          "discounted_cash": 0.08,
          "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": 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": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.11
            },
            {
              "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": 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": 0.11
            },
            {
              "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": 0.08
            },
            {
              "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": 0.08
            },
            {
              "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": 0.13,
              "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": 0.11
            },
            {
              "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": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.13,
              "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": 0.13,
              "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": 0.08
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.11
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.11
            },
            {
              "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": 0.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "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": 0.08
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.13,
              "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": 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": 0.07
            },
            {
              "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": 0.08
            },
            {
              "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": 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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.07
            },
            {
              "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": 0.04
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.11
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "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": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.09
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "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": 0.11
            },
            {
              "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": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "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": 0.11
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.13,
              "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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.08
            }
          ]
        }
      ]
    },
    {
      "description": "HC Aluminum",
      "code_information": [
        {
          "code": "PX-30100134",
          "type": "CDM"
        },
        {
          "code": "82108",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 115,
          "discounted_cash": 74.75,
          "minimum": 21.85,
          "maximum": 95.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "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": 94.3
            },
            {
              "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": 83.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.85,
              "estimated_amount": 21.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 115,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "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": 101.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.85,
              "estimated_amount": 21.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.95
            },
            {
              "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": 94.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 115,
              "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": 63.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 115,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.98,
              "estimated_amount": 29.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "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": 97.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.73,
              "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": 97.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 86.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 115,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": 115,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 115,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.23,
              "estimated_amount": 37.23
            },
            {
              "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": 63.25
            },
            {
              "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": 97.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.85,
              "estimated_amount": 21.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.98,
              "estimated_amount": 29.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "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": 94.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 115
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "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": 94.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.23,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.3
            },
            {
              "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": 115,
              "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": 115,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 86.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 86.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "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": 28.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 97.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.85,
              "estimated_amount": 21.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 25.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.23,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.04,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.55,
              "estimated_amount": 95.55
            },
            {
              "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": 74.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.48,
              "estimated_amount": 25.48
            }
          ]
        }
      ]
    },
    {
      "description": "Copper Sendout",
      "code_information": [
        {
          "code": "PX-30100196",
          "type": "CDM"
        },
        {
          "code": "82525",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 86,
          "discounted_cash": 55.9,
          "minimum": 10.65,
          "maximum": 46.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "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": 86,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.14,
              "estimated_amount": 18.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.65,
              "estimated_amount": 10.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.53,
              "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": 86,
              "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": 50,
              "estimated_amount": 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": 73.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.41,
              "estimated_amount": 12.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "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": 86,
              "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": 86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.41,
              "estimated_amount": 12.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.14,
              "estimated_amount": 18.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.14,
              "estimated_amount": 18.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.41,
              "estimated_amount": 12.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.53,
              "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_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.03,
              "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": 47.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "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": 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": 70.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.41,
              "estimated_amount": 12.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.41,
              "estimated_amount": 12.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.41,
              "estimated_amount": 12.41
            },
            {
              "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": 70.52
            },
            {
              "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": 75.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.53,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "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": 55.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.65,
              "estimated_amount": 10.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.65,
              "estimated_amount": 10.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "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": 43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "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": 73.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "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": 38.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.65,
              "estimated_amount": 10.65
            },
            {
              "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": 62.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.41,
              "estimated_amount": 12.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.07,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "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": 38.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.54,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.53,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 12.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.53,
              "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": 73.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "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": 21.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "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": 38.7
            },
            {
              "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": 47.3
            },
            {
              "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": 70.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cryoglobulin",
      "code_information": [
        {
          "code": "PX-30100212",
          "type": "CDM"
        },
        {
          "code": "82595",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 108,
          "discounted_cash": 70.2,
          "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": 69.34
            },
            {
              "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": 94.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "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": 108,
              "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": 91.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 89.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "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": 59.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 108
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "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": 68.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "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": 88.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 89.53
            },
            {
              "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": 91.8
            },
            {
              "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": 69.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 88.56
            },
            {
              "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": 59.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 91.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.46,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "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": 89.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 68.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 87.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "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": 68.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 108,
              "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": 70.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.34
            },
            {
              "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": 59.94
            },
            {
              "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": 94.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 91.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.79,
              "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": 88.56
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 78.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 59.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.46,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.79,
              "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": 68.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "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": 95.04
            },
            {
              "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": 69.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "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": 69.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.31
            },
            {
              "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": 70.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.46,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "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": 70.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "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": 70.31
            },
            {
              "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": 29.48
            },
            {
              "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": 59.94
            },
            {
              "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": 78.84
            },
            {
              "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": 108,
              "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": 69.34
            },
            {
              "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": 69.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 70.31
            },
            {
              "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": 87.37
            }
          ],
          "minimum": 6.47,
          "maximum": 24.26
        }
      ]
    },
    {
      "description": "HC Vitamin B 12",
      "code_information": [
        {
          "code": "PX-30100214",
          "type": "CDM"
        },
        {
          "code": "82607",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62,
          "discounted_cash": 40.3,
          "minimum": 14.83,
          "maximum": 56.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "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": 45.26
            },
            {
              "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": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "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": 54.56
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 31
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.83,
              "estimated_amount": 14.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "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": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "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": 15.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.08,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.08,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 31
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "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": 62,
              "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": 50,
              "estimated_amount": 31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "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": 45,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.08,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.08,
              "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": 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": 50.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "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": 62,
              "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": 34.1
            },
            {
              "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": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "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": 50.84
            },
            {
              "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": 34.1
            },
            {
              "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": 50.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.83,
              "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": 62,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.83,
              "estimated_amount": 14.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.83,
              "estimated_amount": 14.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "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": 45.26
            },
            {
              "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": 52.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.83,
              "estimated_amount": 14.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "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": 50.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 27.9
            },
            {
              "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": 40.3
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 15.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.08,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.03,
              "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": 46.5
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.08,
              "estimated_amount": 15.08
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.26
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.03,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 50.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.03,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 31
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.55,
              "estimated_amount": 56.55
            },
            {
              "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": "fee schedule",
              "standard_charge_dollar": 29.5,
              "estimated_amount": 29.5
            },
            {
              "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": 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": 50.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 31
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.08,
              "estimated_amount": 15.08
            }
          ]
        }
      ]
    },
    {
      "description": "Cystatin C Sendout",
      "code_information": [
        {
          "code": "PX-30100216",
          "type": "CDM"
        },
        {
          "code": "82610",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 128,
          "discounted_cash": 83.2,
          "minimum": 2.64,
          "maximum": 69.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 93.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "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": 108.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 93.44
            },
            {
              "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": 93.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 93.44
            },
            {
              "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": 108.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.09,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 96
            },
            {
              "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": 57.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.52,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 104.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.52,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.09,
              "estimated_amount": 20.09
            },
            {
              "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": 128,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.52,
              "estimated_amount": 18.52
            },
            {
              "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": 57.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "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": 32
            },
            {
              "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": 57.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.52,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.09,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "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": 128,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "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": 70.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 93.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.71,
              "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": 83.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 104.96
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.52,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 128
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.71,
              "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": 45,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 104.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "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": 64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.71,
              "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": 128,
              "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": 104.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 104.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.52,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.45,
              "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": 104.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.64,
              "estimated_amount": 2.64
            },
            {
              "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": 104.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "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": 112.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "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": 108.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.52,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 93.44
            },
            {
              "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": 64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 104.96
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 18.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.45,
              "estimated_amount": 69.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 108.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 96
            }
          ]
        }
      ]
    },
    {
      "description": "Fatty Acids Nonesterified So",
      "code_information": [
        {
          "code": "PX-30100238",
          "type": "CDM"
        },
        {
          "code": "82725",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 98,
          "discounted_cash": 63.7,
          "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": 62.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 81.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "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": 54.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.92
            },
            {
              "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": 98,
              "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": 98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.92
            },
            {
              "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": 63.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "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": 53.9
            },
            {
              "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": 80.36
            },
            {
              "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": 62.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.9
            },
            {
              "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": 71.54
            },
            {
              "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": 62.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 73.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 81.24
            },
            {
              "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": 85.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 79.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.54
            },
            {
              "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": 63.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.54
            },
            {
              "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": 54.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "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": 61.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "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": 62.92
            },
            {
              "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": 62.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.36
            },
            {
              "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": 26.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.54
            },
            {
              "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": 81.24
            },
            {
              "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": 79.28
            },
            {
              "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": 80.36
            },
            {
              "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": 83.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "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": 98,
              "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": 83.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 73.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.36
            },
            {
              "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": 61.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "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": 54.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 73.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.54
            },
            {
              "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": 61.94
            },
            {
              "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": 63.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.92
            },
            {
              "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": 80.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.39,
              "estimated_amount": 70.39
            },
            {
              "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": 86.24
            },
            {
              "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": 85.95
            },
            {
              "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": 83.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.92
            },
            {
              "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": 98,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 18.96,
          "maximum": 70.39
        }
      ]
    },
    {
      "description": "HC Glucose Quantitative Blood",
      "code_information": [
        {
          "code": "PX-30100261",
          "type": "CDM"
        },
        {
          "code": "82947",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "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": 5.78
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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": "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": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "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": 7.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.93,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": "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/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": 7.92
            },
            {
              "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": 7.38
            },
            {
              "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": 6.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": "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": "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": "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": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.73,
              "estimated_amount": 5.73
            },
            {
              "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": "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": "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 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 HMO QPOS/SELECT [310215]",
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": 2.46
            },
            {
              "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": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.93,
              "estimated_amount": 3.93
            },
            {
              "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": 7.89
            },
            {
              "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.93,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.97,
              "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": 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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "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": 5.69
            },
            {
              "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.73,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.93,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.97,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.73,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.13,
              "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": 9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": 5.78
            },
            {
              "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": 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": 5.78
            },
            {
              "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": "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": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.13,
              "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": 7.46
            },
            {
              "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": 7.28
            },
            {
              "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": 7.89
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.97,
              "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": 5.69
            },
            {
              "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": 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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.93,
              "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": 5.85
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.97,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": 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": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 3.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.97,
              "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": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.74,
              "estimated_amount": 14.74
            },
            {
              "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": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.93,
              "estimated_amount": 3.93
            },
            {
              "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.93,
              "estimated_amount": 3.93
            }
          ],
          "minimum": 3.93,
          "maximum": 14.74
        }
      ]
    },
    {
      "description": "Syringe Only 10 Cc Luer Lock W/Blunt Cannula",
      "code_information": [
        {
          "code": "PX-CH-BD303348",
          "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": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "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": 0.7,
              "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": 0.7,
              "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": 0.7,
              "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": 0.6
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "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": 0.7,
              "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": 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": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "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": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE 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": "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": "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": "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/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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "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": "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": "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 MANAGED MEDICARE [314]",
              "plan_name": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "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": "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": "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": "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "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": "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": "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 OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.7,
              "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": 0.7,
              "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": 0.7,
              "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": 0.7,
              "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": 0.46
            },
            {
              "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": 0.57
            },
            {
              "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": 0.7,
              "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": 0.51
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "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": 0.7,
              "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": 0.39
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "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": 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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC 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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "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": 0.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.58
            },
            {
              "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": "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": "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": "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": "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 MANAGED MEDICARE [314]",
              "plan_name": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.51
            },
            {
              "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": 0.7,
              "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": 0.39
            },
            {
              "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": 0.45
            },
            {
              "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": 0.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "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": "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/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": "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": "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": "Homovanillic Acid Hva Sendout",
      "code_information": [
        {
          "code": "PX-30100289",
          "type": "CDM"
        },
        {
          "code": "83150",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 100,
          "discounted_cash": 65,
          "minimum": 16.45,
          "maximum": 84.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "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": 25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.61,
              "estimated_amount": 16.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.61,
              "estimated_amount": 16.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "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": 82
            },
            {
              "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": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.63,
              "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": 73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "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": 88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.76,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.53,
              "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": 85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.61,
              "estimated_amount": 16.61
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.54,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 100
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "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": 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
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.54,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.54,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55
            },
            {
              "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": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.61,
              "estimated_amount": 16.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.53,
              "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": 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": 55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 22.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.53,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "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": 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": 82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.41,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 100,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.04,
              "estimated_amount": 84.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.11,
              "estimated_amount": 25.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.76,
              "estimated_amount": 22.76
            }
          ]
        }
      ]
    },
    {
      "description": "HC Immunassay Noninfect Agnt Qnt Ria",
      "code_information": [
        {
          "code": "PX-30100296",
          "type": "CDM"
        },
        {
          "code": "83519",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 571,
          "discounted_cash": 371.15,
          "minimum": 12.78,
          "maximum": 69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 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": 502.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.74,
              "estimated_amount": 19.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 285.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 285.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 256.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 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": 371.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 428.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "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": 571,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.32,
              "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": 485.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 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": 416.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 571
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 256.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 256.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 285.5
            },
            {
              "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": 485.35
            },
            {
              "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": 285.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 468.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 468.22
            },
            {
              "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": 256.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 468.22
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 314.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 256.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "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": 468.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 428.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 314.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "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": 45,
              "estimated_amount": 256.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 314.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.74,
              "estimated_amount": 19.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 256.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 428.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 285.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 285.5
            },
            {
              "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": 256.95
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.74,
              "estimated_amount": 19.74
            },
            {
              "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": 314.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "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": 50,
              "estimated_amount": 285.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 285.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 571,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 256.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 285.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 314.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 314.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 468.22
            },
            {
              "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": 468.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "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": 571,
              "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": 468.22
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.32,
              "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": 314.05
            },
            {
              "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": 416.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "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": 256.95
            },
            {
              "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": 285.5
            },
            {
              "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": 468.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 485.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "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": 142.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            }
          ]
        }
      ]
    },
    {
      "description": "HC Troponin Quantitative",
      "code_information": [
        {
          "code": "PX-30100439",
          "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": "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": 50.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "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 [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": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": "UHC 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": "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": "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 [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": "HUMANA [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": "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": "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": "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": "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": "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 PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": "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": "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": "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": "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": "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "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": "MOLINA 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": "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "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": "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": "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": "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 58.14
            },
            {
              "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": 59.06
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": 80.96
            },
            {
              "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": 59.89
            },
            {
              "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": "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 NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 12.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.59,
              "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": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 12.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.38,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 12.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "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": "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": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.43
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "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": "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": "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 [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 92
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 12.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.59,
              "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": 58.14
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 12.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.59,
              "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": 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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "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": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            }
          ],
          "minimum": 12.47,
          "maximum": 46.76
        }
      ]
    },
    {
      "description": "HC Uric Acid Blood",
      "code_information": [
        {
          "code": "PX-30100445",
          "type": "CDM"
        },
        {
          "code": "84550",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17,
          "discounted_cash": 11.05,
          "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": 10.91
            },
            {
              "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": 10.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 12.41
            },
            {
              "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": 17,
              "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": 14.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.57,
              "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": 50,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "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": 14.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.07
            },
            {
              "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": 11.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.52,
              "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": 9.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.57,
              "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": 10.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.41
            },
            {
              "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": 9.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.75
            },
            {
              "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": 10.74
            },
            {
              "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": 14.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.07
            },
            {
              "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": 13.94
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.52,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.57,
              "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": 11.07
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.75,
              "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": 17,
              "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": 10.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.41
            },
            {
              "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": 17,
              "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": 10.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "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": 4.64
            },
            {
              "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": 9.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.61,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.52,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.61,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.52,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.52,
              "estimated_amount": 4.52
            },
            {
              "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": 9.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "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": 11.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.75,
              "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": 13.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "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": 10.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "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": 10.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.75,
              "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": 13.94
            },
            {
              "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": 14.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "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": 14.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.74
            },
            {
              "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": 10.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.75
            },
            {
              "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": 14.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.91
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.52,
              "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": 14.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.61,
              "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": 10.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.57,
              "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": 12.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.95,
              "estimated_amount": 16.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 12.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.52,
              "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": 10.91
            },
            {
              "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": 13.75
            }
          ],
          "minimum": 4.52,
          "maximum": 16.95
        }
      ]
    },
    {
      "description": "HC Vasopressin So",
      "code_information": [
        {
          "code": "PX-30100452",
          "type": "CDM"
        },
        {
          "code": "84588",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 338,
          "discounted_cash": 219.7,
          "minimum": 29.11,
          "maximum": 127.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "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": 277.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "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": 152.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.11,
              "estimated_amount": 29.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 338
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.11,
              "estimated_amount": 29.11
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.64,
              "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": 246.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.11,
              "estimated_amount": 29.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 152.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.6,
              "estimated_amount": 49.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "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": 277.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 253.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "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": 169
            },
            {
              "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": 152.1
            },
            {
              "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": 169
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "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": 219.7
            },
            {
              "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": 277.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 152.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 253.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "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": 185.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.94,
              "estimated_amount": 33.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 152.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 253.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.94,
              "estimated_amount": 33.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.11,
              "estimated_amount": 29.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.6,
              "estimated_amount": 49.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.28,
              "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": 45,
              "estimated_amount": 152.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "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": 287.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "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": 84.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.94,
              "estimated_amount": 33.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.6,
              "estimated_amount": 49.6
            },
            {
              "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": 246.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.94,
              "estimated_amount": 33.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "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": 297.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.95,
              "estimated_amount": 78.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 152.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 152.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.94,
              "estimated_amount": 33.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 33.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.64,
              "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": 287.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.94,
              "estimated_amount": 33.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 169
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 152.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.28,
              "estimated_amount": 127.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.94,
              "estimated_amount": 33.94
            },
            {
              "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": 152.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "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": 287.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            }
          ]
        }
      ]
    },
    {
      "description": "Vitamin a Sendout",
      "code_information": [
        {
          "code": "PX-30100453",
          "type": "CDM"
        },
        {
          "code": "84590",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43,
          "discounted_cash": 27.95,
          "minimum": 9.95,
          "maximum": 43.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.25
            },
            {
              "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": 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": 36.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "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": 35.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.95,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "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": 37.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.61,
              "estimated_amount": 11.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "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": 43,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.95,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.94,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.94,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "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": 35.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.61,
              "estimated_amount": 11.61
            },
            {
              "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": 27.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.19,
              "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": 11.61,
              "estimated_amount": 11.61
            },
            {
              "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": 21.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.73,
              "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": 36.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.61,
              "estimated_amount": 11.61
            },
            {
              "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": 23.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.25
            },
            {
              "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": 31.39
            },
            {
              "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": 19.35
            },
            {
              "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": 19.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.61,
              "estimated_amount": 11.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.61,
              "estimated_amount": 11.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "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": 21.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.95,
              "estimated_amount": 9.95
            },
            {
              "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": 10.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.95,
              "estimated_amount": 9.95
            },
            {
              "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": 36.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "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": 43,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.61,
              "estimated_amount": 11.61
            },
            {
              "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": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "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": 43,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "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": 36.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.61,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.17,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.54,
              "estimated_amount": 43.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.94,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hcg Qualitative",
      "code_information": [
        {
          "code": "PX-30100460",
          "type": "CDM"
        },
        {
          "code": "84703",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 32,
          "discounted_cash": 20.8,
          "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": 20.54
            },
            {
              "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": 20.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "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": 17.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.52,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "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": 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": 27.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.52,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.53
            },
            {
              "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": 32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.52,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.6,
              "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": 20.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 23.36
            },
            {
              "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": 17.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.6,
              "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": 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": 26.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 20.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "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": 17.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "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": 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": 17.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "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": 28.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.36
            },
            {
              "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": 27.2
            },
            {
              "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": 20.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.54
            },
            {
              "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": 20.83
            },
            {
              "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": 26.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.52,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "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": 26.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 17.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.52,
              "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": 20.83
            },
            {
              "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": 23.36
            },
            {
              "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": 20.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.52,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.89
            },
            {
              "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": 20.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.6,
              "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": 20.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "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": 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": 25.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.52,
              "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": 17.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "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": 26.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "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": 20.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "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": 8.74
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.6,
              "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": 27.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.2,
              "estimated_amount": 28.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "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": 27.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 7.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "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": 20.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.83
            }
          ],
          "minimum": 7.52,
          "maximum": 28.2
        }
      ]
    },
    {
      "description": "HC Iadna Candida Species Amp Probe",
      "code_information": [
        {
          "code": "PX-30600322",
          "type": "CDM"
        },
        {
          "code": "87481",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 168,
          "discounted_cash": 109.2,
          "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": 107.86
            },
            {
              "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": 135.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 137.76
            },
            {
              "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": 137.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 147.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 107.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 137.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 122.64
            },
            {
              "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": 122.64
            },
            {
              "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": 168,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 106.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 137.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 107.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 107.86
            },
            {
              "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": 142.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 106.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 92.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 122.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 168
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 93.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "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": 106.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 107.86
            },
            {
              "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": 109.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 106.18
            },
            {
              "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": 139.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 126
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 137.76
            },
            {
              "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": 92.4
            },
            {
              "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": 147.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 168,
              "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": 109.37
            },
            {
              "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": 106.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 107.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 122.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 137.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 92.4
            },
            {
              "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": 45.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 126
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 107.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 126
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 92.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 139.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 137.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 139.27
            },
            {
              "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": 93.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 92.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 107.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 109.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 92.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 122.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 92.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "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": 142.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 147.84
            },
            {
              "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": 107.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 109.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 109.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 135.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 106.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 137.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 106.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "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": 107.86
            },
            {
              "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": 107.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "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": 168,
              "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": 93.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 142.8
            },
            {
              "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": 106.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 93.24
            },
            {
              "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": 109.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 122.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 107.86
            }
          ],
          "minimum": 51.28,
          "maximum": 131.59
        }
      ]
    },
    {
      "description": "HC Propoxyphene So",
      "code_information": [
        {
          "code": "PX-30100535",
          "type": "CDM"
        },
        {
          "code": "80367",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 163,
          "discounted_cash": 105.95,
          "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": 104.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 131.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 104.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 106.11
            },
            {
              "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": 106.11
            },
            {
              "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": 103.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 163,
              "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": 131.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 135.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 122.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 133.66
            },
            {
              "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": 135.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 104.65
            },
            {
              "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": 106.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 103.02
            },
            {
              "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": 103.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "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": 118.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 133.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 104.65
            },
            {
              "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": 103.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 163,
              "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": 118.99
            },
            {
              "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": 104.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 106.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 122.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.65
            },
            {
              "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": 163,
              "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": 163,
              "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": 104.65
            },
            {
              "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": 104.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 133.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 103.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 163,
              "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": 138.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 103.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "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": 105.95
            },
            {
              "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": 90.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 90.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 103.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 104.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 133.66
            },
            {
              "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": 133.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 122.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 135.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "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": 90.47
            },
            {
              "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": 143.44
            },
            {
              "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": 44.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 106.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 104.65
            },
            {
              "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": 104.65
            },
            {
              "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": 89.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 90.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 163,
              "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": 104.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 104.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 163,
              "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": 163,
              "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": 138.55
            },
            {
              "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": 133.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 163
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.65
            },
            {
              "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": 138.55
            },
            {
              "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": 138.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 138.55
            },
            {
              "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": 142.95
            },
            {
              "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": 142.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 103.02
            },
            {
              "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": 163,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 133.66
            },
            {
              "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": 163,
              "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": 133.66
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "Amino Acids Quant More Than 5 Sendout",
      "code_information": [
        {
          "code": "PX-30100587",
          "type": "CDM"
        },
        {
          "code": "82139",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 470,
          "discounted_cash": 305.5,
          "minimum": 5.76,
          "maximum": 63.26,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 211.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 352.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 352.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "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": 399.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 343.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 385.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 211.5
            },
            {
              "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": 211.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "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": 385.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "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": 399.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "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": 385.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 385.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "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": 45,
              "estimated_amount": 211.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 235
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 385.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 211.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 343.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "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": 343.1
            },
            {
              "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": 385.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.64,
              "estimated_amount": 24.64
            },
            {
              "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": 413.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "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": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.64,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 343.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "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": 258.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 343.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 211.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 343.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 470
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.64,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 385.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 235
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 352.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 211.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 211.5
            },
            {
              "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": 305.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.5
            },
            {
              "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": 211.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "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": 211.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "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": 117.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "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": 385.4
            }
          ]
        }
      ]
    },
    {
      "description": "Drainage Bag 2000ml Bedside Velcro Hanger",
      "code_information": [
        {
          "code": "PX-CH-A1-ND2000R",
          "type": "CDM"
        },
        {
          "code": "A4357",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.83,
          "discounted_cash": 1.84,
          "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": 1.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.41
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 2.41
            },
            {
              "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": 2.83,
              "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": 1.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.79
            },
            {
              "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": 2.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.79
            },
            {
              "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": 2.83,
              "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": 2.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.84
            },
            {
              "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": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 0.77
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.83,
              "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": 2.32
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 1.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.12
            },
            {
              "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": 2.07
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.29
            },
            {
              "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": 2.83,
              "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": 1.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.12
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.83,
              "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": 1.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 1.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.83,
              "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": 2.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.82
            },
            {
              "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": 1.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 1.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 1.82
            },
            {
              "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": 1.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.41
            },
            {
              "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": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.32
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.83,
              "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": 2.83,
              "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": 2.49
            },
            {
              "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": 2.83,
              "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": 1.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            },
            {
              "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": 1.57
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.83,
              "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": 2.07
            },
            {
              "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": 2.83,
              "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": 2.83,
              "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": 2.41
            },
            {
              "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": 2.32
            },
            {
              "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": 2.83,
              "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": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.83,
              "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": 2.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.56
            },
            {
              "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": 2.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.83,
              "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": 2.83,
              "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": 2.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.83,
              "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": 2.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.12
            },
            {
              "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": 2.83,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 9.27,
          "discounted_cash": 6.03,
          "payers_information": [
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.03
            },
            {
              "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": 9.27,
              "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": 5.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.88
            },
            {
              "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": 5.95
            },
            {
              "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": 5.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.95
            },
            {
              "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": 2.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.95
            },
            {
              "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": 9.27,
              "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": 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": 7.88
            },
            {
              "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": 9.27,
              "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": 7.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.86
            },
            {
              "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": 5.86
            },
            {
              "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": 9.27,
              "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": 9.27,
              "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": 9.27,
              "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": 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": 7.88
            },
            {
              "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": 8.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.88
            },
            {
              "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": 5.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.95
            },
            {
              "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": 6.03
            },
            {
              "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": 9.27,
              "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": 5.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.1
            },
            {
              "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": 7.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 7.88
            },
            {
              "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": 7.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 6.03
            },
            {
              "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": 5.14
            },
            {
              "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": 5.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 9.27,
              "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": 9.27,
              "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": 6.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.27,
              "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": 9.27,
              "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": 9.27,
              "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": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.1
            },
            {
              "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": 9.27,
              "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": 9.27,
              "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": 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": 7.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 8.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 5.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.95
            },
            {
              "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": 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": 6.77
            },
            {
              "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": 7.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 9.27,
              "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": 7.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 7.88
            },
            {
              "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": 9.27,
              "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": 9.27,
              "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": 6.77
            },
            {
              "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": 9.27,
              "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": 9.27,
              "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": 9.27,
              "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": 5.86
            },
            {
              "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": 5.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.6
            },
            {
              "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": 9.27,
              "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": 9.27,
              "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": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 9.27,
              "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": 7.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 5.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.1
            },
            {
              "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": 9.27,
              "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": 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": 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": 5.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.27,
              "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": 9.27,
              "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": 5.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "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": 6.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Chromatography Qn Column Single So",
      "code_information": [
        {
          "code": "PX-30100623",
          "type": "CDM"
        },
        {
          "code": "82542",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 377,
          "discounted_cash": 245.05,
          "minimum": 16.74,
          "maximum": 90.34,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.29,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 320.45
            },
            {
              "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": 320.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 377,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 275.21
            },
            {
              "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": 275.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 309.14
            },
            {
              "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": 169.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.29,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            },
            {
              "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": 309.14
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.39,
              "estimated_amount": 26.39
            },
            {
              "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": 377,
              "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": 207.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            },
            {
              "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": 377,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 245.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.39,
              "estimated_amount": 26.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 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": 309.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 282.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "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": 169.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "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": 331.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.29,
              "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": 282.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "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": 188.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 207.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 377
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 94.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.39,
              "estimated_amount": 26.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 282.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "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": 169.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            },
            {
              "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": 309.14
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "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": 50,
              "estimated_amount": 188.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 188.5
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe Only Piston 70cc Irrigation",
      "code_information": [
        {
          "code": "PX-CH-BA802065",
          "type": "CDM"
        },
        {
          "code": "A4322",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.17,
          "discounted_cash": 0.76,
          "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": 0.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "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": 1.17,
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 0.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.17,
              "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": 0.75
            },
            {
              "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": 1.17,
              "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": 1.17,
              "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": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 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": 1.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.76
            },
            {
              "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": 1.17,
              "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": 0.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.75
            },
            {
              "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": 1.17,
              "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": 1.17,
              "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": 0.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.96
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "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": 1.17,
              "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": 1.17,
              "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": 1.17,
              "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": 0.75
            },
            {
              "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": 1.17,
              "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": 1.17,
              "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": 0.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.17,
              "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": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 0.96
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 0.65
            },
            {
              "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": 0.76
            },
            {
              "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": 1.17,
              "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": 1.17,
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.03
            },
            {
              "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": 0.74
            },
            {
              "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": 1.17,
              "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": 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": 0.96
            },
            {
              "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": 1.17,
              "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": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 0.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 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": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 0.75
            },
            {
              "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": 1.17,
              "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": 0.88
            },
            {
              "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": 0.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 1.17,
              "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": 0.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 0.65
            },
            {
              "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": 1.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.17
            },
            {
              "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": 0.97
            },
            {
              "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": 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": 1.17,
              "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": 0.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "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": 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": 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": 0.65
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 1.17,
              "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": 0.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.75
            },
            {
              "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": 1.17,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Ctf Std Wear Up to 1 1/4 in Centerpoint",
      "code_information": [
        {
          "code": "PX-CH-HO3722",
          "type": "CDM"
        },
        {
          "code": "A4414",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.74,
          "discounted_cash": 1.78,
          "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": 1.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "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": 2.74,
              "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": 2.33
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 2
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.74,
              "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": 1.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "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": 2.4
            },
            {
              "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": 1.76
            },
            {
              "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": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.73
            },
            {
              "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": 2.74,
              "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": 2.74,
              "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": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 1.76
            },
            {
              "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": 1.76
            },
            {
              "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": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 2.74,
              "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": 1.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.74,
              "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": 2.06
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.76
            },
            {
              "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": 2.74,
              "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": 1.51
            },
            {
              "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": 2.74,
              "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": 2.33
            },
            {
              "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": 2.74,
              "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": 2.74,
              "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": 2.25
            },
            {
              "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": 2.74,
              "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": 1.73
            },
            {
              "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": 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": 2.25
            },
            {
              "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": 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": 2.74,
              "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": 2.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 2.74,
              "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": 1.78
            },
            {
              "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": 1.78
            },
            {
              "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": 2.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.33
            },
            {
              "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": 2.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 2.74,
              "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": 1.51
            },
            {
              "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": 1.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.76
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 1.78
            },
            {
              "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": 2.74,
              "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": 1.76
            },
            {
              "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": 1.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 2.74,
              "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": 1.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "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": 2.74,
              "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": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 1.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 2.74,
              "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": 2.74,
              "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": 2.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.73
            },
            {
              "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": 2.74,
              "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": 0.75
            },
            {
              "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": 2.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 1.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "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": 2.74,
              "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": 2.74,
              "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": 1.52
            },
            {
              "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": 2.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.27
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrocolloid Paste Medihoney 1.5 Oz",
      "code_information": [
        {
          "code": "PX-CH-DUM31501",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23.84,
          "discounted_cash": 15.5,
          "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": 15.31
            },
            {
              "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": 15.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.31
            },
            {
              "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": 19.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 23.84,
              "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": 13.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.4
            },
            {
              "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": 20.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.88
            },
            {
              "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": 23.84,
              "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": 13.23
            },
            {
              "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": 15.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 23.84,
              "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": 20.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 23.84,
              "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": 23.84,
              "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": 15.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 20.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 15.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 23.84,
              "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": 15.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 19.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.11
            },
            {
              "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": 15.07
            },
            {
              "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": 15.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.26
            },
            {
              "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": 20.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.88
            },
            {
              "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": 15.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 15.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.26
            },
            {
              "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": 17.4
            },
            {
              "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": 23.84,
              "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": 17.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.31
            },
            {
              "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": 19.55
            },
            {
              "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": 6.51
            },
            {
              "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": 23.84,
              "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": 13.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.11
            },
            {
              "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": 23.84,
              "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": 15.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 20.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 20.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 23.84,
              "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": 23.84,
              "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": 20.26
            },
            {
              "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": 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": 15.31
            },
            {
              "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": 15.31
            },
            {
              "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": 13.23
            },
            {
              "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": 20.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 23.84,
              "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": 15.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.84,
              "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": 19.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 23.84,
              "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": 13.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.4
            },
            {
              "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": 15.07
            },
            {
              "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": 15.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.4
            },
            {
              "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": 15.31
            },
            {
              "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": 19.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.55
            },
            {
              "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": 19.55
            }
          ]
        }
      ]
    },
    {
      "description": "Perineal Cleanser Spray 8 Oz Cardinal",
      "code_information": [
        {
          "code": "PX-CH-55CSCPRSK8",
          "type": "CDM"
        },
        {
          "code": "A4335",
          "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": "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": "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": "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": "MUTUAL HEALTH SERVICES MMO [485260]",
              "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": "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": 2.27,
              "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": 1.43
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "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": 1.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "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": 2.27,
              "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": 2.27,
              "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": 1.25
            },
            {
              "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"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "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": 1.93
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "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": 2.27,
              "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": 2.27,
              "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": 1.46
            },
            {
              "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": 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": 1.48
            },
            {
              "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": 2.27,
              "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": 1.66
            },
            {
              "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": 2.27,
              "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": 2.27,
              "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": 2.27,
              "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": 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": "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": "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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "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": 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": 1.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.84
            },
            {
              "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": 1.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "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": 1.43
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "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": "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": "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": "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.48
            },
            {
              "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": 1.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "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": 2.27,
              "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": 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": 1.26
            },
            {
              "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": 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": 1.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "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": 1.84
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "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": 1.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "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": "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 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": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "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": 0.62
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "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": 2.27,
              "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": 2.27,
              "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": 2.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.27,
              "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": 1.93
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "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": 1.26
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "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": 2.27,
              "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": 2.27,
              "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": 1.86
            },
            {
              "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": 2.27,
              "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": 1.88
            }
          ]
        }
      ]
    },
    {
      "description": "HC Opiates 1 or More So",
      "code_information": [
        {
          "code": "PX-30100834",
          "type": "CDM"
        },
        {
          "code": "80361",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 148,
          "discounted_cash": 96.2,
          "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": 95.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "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": 121.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "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": 148,
              "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": 148,
              "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": 148,
              "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": 125.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.14,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 148,
              "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": 82.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 96.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 95.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 148,
              "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": 125.8
            },
            {
              "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": 125.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "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": 81.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 96.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 148,
              "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": 122.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 148,
              "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": 121.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 93.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 125.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.35
            },
            {
              "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": 119.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "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": 93.54
            },
            {
              "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": 93.54
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.14,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 122.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 148
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 93.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.14,
              "estimated_amount": 23.14
            },
            {
              "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": 95.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 148,
              "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": 130.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 148,
              "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": 121.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "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": 125.8
            },
            {
              "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": 96.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "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": 129.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 129.8
            },
            {
              "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": 82.14
            },
            {
              "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": 121.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "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": 108.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 82.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 122.69
            },
            {
              "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": 95.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 108.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "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": 40.4
            },
            {
              "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": 148,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 23.14,
          "maximum": 23.14
        }
      ]
    },
    {
      "description": "HC Anti Phosphatidylserine Ab",
      "code_information": [
        {
          "code": "PX-30200015",
          "type": "CDM"
        },
        {
          "code": "86148",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 587,
          "discounted_cash": 381.55,
          "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": 376.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.85
            },
            {
              "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": 516.56
            },
            {
              "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": 486.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.85
            },
            {
              "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": 481.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "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": 370.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "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": 587,
              "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": 428.51
            },
            {
              "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": 428.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.85
            },
            {
              "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": 382.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 440.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 474.88
            },
            {
              "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": 376.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 486.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.85
            },
            {
              "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": 587,
              "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": 481.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 325.79
            },
            {
              "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": 370.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "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": 498.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.98
            },
            {
              "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": 322.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.47,
              "estimated_amount": 23.47
            },
            {
              "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": 325.79
            },
            {
              "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": 498.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 587
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.98
            },
            {
              "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": 376.85
            },
            {
              "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": 587,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 486.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.85
            },
            {
              "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": 382.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "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": 325.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.98
            },
            {
              "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": 514.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 440.25
            },
            {
              "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": 376.85
            },
            {
              "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": 481.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "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": 325.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 440.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "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": 381.55
            },
            {
              "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": 474.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.85
            },
            {
              "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": 160.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "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": 514.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.47,
              "estimated_amount": 23.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.85
            },
            {
              "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": 481.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.51
            },
            {
              "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": 376.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.26,
              "estimated_amount": 60.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.95
            },
            {
              "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": 370.98
            }
          ],
          "minimum": 23.47,
          "maximum": 60.26
        }
      ]
    },
    {
      "description": "Inhibin a Sendout",
      "code_information": [
        {
          "code": "PX-30200045",
          "type": "CDM"
        },
        {
          "code": "86336",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 78,
          "discounted_cash": 50.7,
          "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": 50.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "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": 64.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 68.64
            },
            {
              "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": 43.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 43.29
            },
            {
              "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": 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": 50.78
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "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": 63.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "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": 21.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.75,
              "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": 78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "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": 50.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.37,
              "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": 66.3
            },
            {
              "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": 66.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.75,
              "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": 66.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.59,
              "estimated_amount": 15.59
            },
            {
              "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": 64.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "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": 63.96
            },
            {
              "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": 49.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 49.3
            },
            {
              "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": 68.41
            },
            {
              "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": 50.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.37,
              "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": 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": 64.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.59,
              "estimated_amount": 15.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 50.7
            },
            {
              "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": 50.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 63.1
            },
            {
              "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": 43.29
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "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": 50.78
            },
            {
              "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": 68.41
            },
            {
              "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": 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": 56.94
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.59,
              "estimated_amount": 15.59
            },
            {
              "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": 66.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.59,
              "estimated_amount": 15.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "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": 50.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.59,
              "estimated_amount": 15.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.59,
              "estimated_amount": 15.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 43.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "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": 63.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 58.5
            },
            {
              "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": 56.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.46,
              "estimated_amount": 58.46
            },
            {
              "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": 42.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 15.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.75,
              "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": 63.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.59,
              "estimated_amount": 15.59
            }
          ],
          "minimum": 15.59,
          "maximum": 58.46
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Mother Angeline Mccrory",
      "code_information": [
        {
          "code": "PX-65900206",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 255.56,
          "discounted_cash": 166.11,
          "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": 64.2,
              "estimated_amount": 164.07
            },
            {
              "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": 140.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 164.07
            },
            {
              "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": 166.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 217.23
            },
            {
              "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": 164.07
            },
            {
              "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": 217.23
            },
            {
              "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": 224.13
            },
            {
              "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": 166.37
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 217.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 255.56,
              "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": 255.56,
              "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": 211.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 164.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 255.56,
              "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": 140.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 164.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 209.56
            },
            {
              "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": 211.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 140.56
            },
            {
              "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": 209.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 164.07
            },
            {
              "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": 206.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 166.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 164.07
            },
            {
              "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": 141.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 140.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 217.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 164.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 206.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 209.56
            },
            {
              "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": 161.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 191.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 140.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 217.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 209.56
            },
            {
              "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": 186.56
            },
            {
              "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": 224.13
            },
            {
              "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": 161.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 166.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 209.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 141.84
            },
            {
              "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": 141.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 161.51
            },
            {
              "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": 161.51
            },
            {
              "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": 164.07
            },
            {
              "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": 69.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 255.56,
              "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": 217.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 140.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 186.56
            },
            {
              "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": 217.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 164.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 217.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 211.86
            },
            {
              "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": 255.56,
              "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": 191.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 186.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 166.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 209.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 191.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 224.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 141.84
            },
            {
              "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": 209.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 217.23
            },
            {
              "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": 164.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 186.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 217.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 217.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 255.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 164.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 140.56
            },
            {
              "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": 209.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 255.56,
              "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": 255.56,
              "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": 255.56,
              "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": 217.23
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hiv 1 and 2 Single Result",
      "code_information": [
        {
          "code": "PX-30200111",
          "type": "CDM"
        },
        {
          "code": "86703",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 38,
          "discounted_cash": 24.7,
          "minimum": 11.76,
          "maximum": 51.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "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": 19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "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": 13.71,
              "estimated_amount": 13.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.76,
              "estimated_amount": 11.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.71,
              "estimated_amount": 13.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.5,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 20.9
            },
            {
              "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": 32.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.71,
              "estimated_amount": 13.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.5,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.71,
              "estimated_amount": 13.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "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": 9.5
            },
            {
              "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": 17.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.4,
              "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": 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": 27.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.76,
              "estimated_amount": 11.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 31.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "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": 38,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.71,
              "estimated_amount": 13.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.71,
              "estimated_amount": 13.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "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": 31.16
            },
            {
              "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": 17.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "UHC 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.76,
              "estimated_amount": 11.76
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.5,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.71,
              "estimated_amount": 13.71
            },
            {
              "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": 17.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.4,
              "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": 45,
              "estimated_amount": 17.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "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": 32.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 32.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 27.74
            },
            {
              "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": 19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "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": 31.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 24.7
            },
            {
              "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": 33.44
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.4,
              "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": 31.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.76,
              "estimated_amount": 11.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.1
            },
            {
              "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": 38,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Toxoplasma Igm Antibody",
      "code_information": [
        {
          "code": "PX-30200136",
          "type": "CDM"
        },
        {
          "code": "86778",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39,
          "discounted_cash": 25.35,
          "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": 25.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.41,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.04,
              "estimated_amount": 21.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "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": 39,
              "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": 21.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.04,
              "estimated_amount": 21.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 25.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "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": 21.65
            },
            {
              "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": 28.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.55,
              "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": 39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.41,
              "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": 25.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "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": 25.39
            },
            {
              "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": 25.35
            },
            {
              "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": 21.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.41,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 33.15
            },
            {
              "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": 10.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.41,
              "estimated_amount": 14.41
            },
            {
              "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": 25.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 39,
              "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": 33.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.41,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 31.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "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": 25.04
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.41,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "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": 33.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.41,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.04,
              "estimated_amount": 21.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "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": 21.65
            },
            {
              "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": 34.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.55,
              "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": 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": 34.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 25.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.04,
              "estimated_amount": 54.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "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": 34.2
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 21.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.13,
              "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": 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": 32.33
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.13,
              "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": 28.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.55,
              "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": 39,
              "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": 25.04
            },
            {
              "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": 31.98
            },
            {
              "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": 24.65
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 14.41,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.55,
              "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": 29.25
            },
            {
              "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": 25.39
            }
          ],
          "minimum": 14.41,
          "maximum": 54.04
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Up to 2 1/2 in Active Life",
      "code_information": [
        {
          "code": "PX-CH-CV4005-98",
          "type": "CDM"
        },
        {
          "code": "A4388",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.88,
          "discounted_cash": 5.12,
          "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": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 7.88,
              "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": 6.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.88,
              "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": 5.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 5.13
            },
            {
              "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": 4.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.98
            },
            {
              "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": 7.88,
              "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": 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": 4.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 6.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 6.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "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": 6.7
            },
            {
              "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": 6.46
            },
            {
              "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": 5.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.98
            },
            {
              "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": 6.46
            },
            {
              "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": 7.88,
              "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": 5.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 7.88,
              "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": 5.06
            },
            {
              "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": 6.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "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": 7.88,
              "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": 6.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "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": 4.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 7.88,
              "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": 6.93
            },
            {
              "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": 7.88,
              "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": 4.37
            },
            {
              "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": 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": 6.37
            },
            {
              "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": 5.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 7.88,
              "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": 7.88,
              "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": 6.46
            },
            {
              "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": 4.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 7.88,
              "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": 5.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 4.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "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": 5.06
            },
            {
              "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": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 7.88,
              "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": 4.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 5.13
            },
            {
              "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": 6.7
            },
            {
              "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": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.88,
              "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": 5.06
            },
            {
              "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": 5.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.7
            },
            {
              "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": 4.33
            },
            {
              "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": 2.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "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": 6.91
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sickle Cell Screen So",
      "code_information": [
        {
          "code": "PX-30500134",
          "type": "CDM"
        },
        {
          "code": "85660",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 99,
          "discounted_cash": 64.35,
          "minimum": 4.72,
          "maximum": 20.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.07,
              "estimated_amount": 8.07
            },
            {
              "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": 87.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.79,
              "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": 81.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "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": 72.27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "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": 24.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.07,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.72,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "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": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.79,
              "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": 81.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 64.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "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": 81.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.72,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.72,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "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": 72.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "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": 81.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.07,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "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": 84.15
            },
            {
              "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": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "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": 54.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.79,
              "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": 54.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "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": 84.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.57,
              "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": 84.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.51,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.72,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.15,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.51,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 99,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.66,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            }
          ]
        }
      ]
    },
    {
      "description": "Lotion Special Care 4 Oz Fragrance Free",
      "code_information": [
        {
          "code": "PX-CH-BA2004C",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.32,
          "discounted_cash": 3.46,
          "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": 3.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.42
            },
            {
              "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": 3.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.3
            },
            {
              "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": 5.32,
              "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": 3.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.36
            },
            {
              "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": 5.32,
              "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": 3.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 5.32,
              "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": 4.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.52
            },
            {
              "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": 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": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 3.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.41
            },
            {
              "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": 4.52
            },
            {
              "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": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 2.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.32,
              "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": 4.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 4.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 3.88
            },
            {
              "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": 2.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.88
            },
            {
              "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": 3.88
            },
            {
              "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": 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": 4.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.42
            },
            {
              "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": 3.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.88
            },
            {
              "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": 2.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 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": 4.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.95
            },
            {
              "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": 1.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.93
            },
            {
              "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": 2.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 3.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.93
            },
            {
              "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": 3.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 2.93
            },
            {
              "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": 5.32,
              "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": 3.36
            },
            {
              "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": 5.32,
              "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": 4.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.42
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 4.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.99
            },
            {
              "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": 3.46
            },
            {
              "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": 5.32,
              "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": 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": 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": 3.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 3.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.32,
              "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": 5.32,
              "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": 4.36
            },
            {
              "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": 4.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 4.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 5.32,
              "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": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "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": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Gauze Drsg Bordered 6\"\" X 6\"\" Reliamed\"",
      "code_information": [
        {
          "code": "PX-CH-ZGB66",
          "type": "CDM"
        },
        {
          "code": "A6219",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.94,
          "discounted_cash": 0.61,
          "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": 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": 0.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "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": 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": 0.6
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.77
            },
            {
              "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": 0.94,
              "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": 0.94,
              "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": 0.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.52
            },
            {
              "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": 0.94,
              "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": 0.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "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": 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": 0.77
            },
            {
              "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": 0.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.6
            },
            {
              "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": 0.94,
              "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": 0.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.94,
              "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": 0.94
            },
            {
              "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": 0.94,
              "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": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "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": 0.94,
              "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": 0.94,
              "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": 0.6
            },
            {
              "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": 0.76
            },
            {
              "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": 0.6
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.52
            },
            {
              "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": 0.94,
              "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": 0.94,
              "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": 0.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.94,
              "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": 0.94,
              "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": 0.69
            },
            {
              "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": 0.94,
              "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": 0.94,
              "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": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "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": 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": 0.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.94,
              "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": 0.94,
              "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": 0.94,
              "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": 0.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.69
            },
            {
              "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": 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": 0.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.59
            },
            {
              "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": 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": 0.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.71
            },
            {
              "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": 0.94,
              "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": 0.94,
              "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": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.8
            },
            {
              "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": 0.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.94,
              "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": 0.94,
              "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": 0.52
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "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": 0.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.94,
              "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": 0.94,
              "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": 0.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "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": 0.94,
              "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": 0.77
            },
            {
              "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": 0.94,
              "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": 0.59
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Ctf Ext Wear Up to 4 in Sur-Fit",
      "code_information": [
        {
          "code": "PX-CH-CV4019-05",
          "type": "CDM"
        },
        {
          "code": "A4410",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.53,
          "discounted_cash": 10.74,
          "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": 10.61
            },
            {
              "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": 16.53,
              "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": 14.55
            },
            {
              "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": 16.53,
              "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": 13.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.55
            },
            {
              "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": 9.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 9.09
            },
            {
              "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": 10.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 10.61
            },
            {
              "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": 13.55
            },
            {
              "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": 14.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.07
            },
            {
              "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": 13.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 13.7
            },
            {
              "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": 16.53,
              "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": 12.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 9.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.07
            },
            {
              "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": 16.53,
              "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": 16.53,
              "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": 16.53,
              "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": 14.05
            },
            {
              "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": 16.53,
              "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": 9.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 10.61
            },
            {
              "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": 16.53,
              "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": 14.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 12.07
            },
            {
              "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": 16.53,
              "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": 16.53,
              "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": 4.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.61
            },
            {
              "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": 10.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 9.17
            },
            {
              "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": 16.53,
              "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": 13.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 12.07
            },
            {
              "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": 9.09
            },
            {
              "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": 16.53,
              "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": 13.55
            },
            {
              "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": 9.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 14.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.07
            },
            {
              "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": 10.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 14.05
            },
            {
              "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": 16.53,
              "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": 16.53,
              "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": 10.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.76
            },
            {
              "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": 13.7
            },
            {
              "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": 16.53,
              "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": 14.05
            },
            {
              "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": 10.61
            },
            {
              "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": 10.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 14.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.09
            },
            {
              "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": 12.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.05
            },
            {
              "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": 16.53,
              "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": 16.53,
              "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": 14.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.05
            },
            {
              "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": 14.5
            },
            {
              "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": 10.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.53,
              "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": 16.53,
              "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": 14.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.45
            },
            {
              "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": 10.76
            },
            {
              "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": 10.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.37
            }
          ]
        }
      ]
    },
    {
      "description": "Trach Tie Foam Posey Adult 13 in-24 In",
      "code_information": [
        {
          "code": "PX-CH-PO8197-L",
          "type": "CDM"
        },
        {
          "code": "A7526",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.69,
          "discounted_cash": 1.1,
          "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": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 1.69,
              "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": 1.69,
              "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": 1.69,
              "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": 0.93
            },
            {
              "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": 1.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.07
            },
            {
              "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": 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": 1.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 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": 1.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.4
            },
            {
              "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": 1.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.39
            },
            {
              "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": 0.94
            },
            {
              "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": 1.69,
              "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": 1.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.44
            },
            {
              "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": 1.4
            },
            {
              "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": 1.44
            },
            {
              "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": 1.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.93
            },
            {
              "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": 1.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 1.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.69,
              "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": 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": 1.23
            },
            {
              "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.69,
              "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": 1.48
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 1.69,
              "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": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 1.1
            },
            {
              "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": 1.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.69
            },
            {
              "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": 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": 1.39
            },
            {
              "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": 1.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.08
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.27
            },
            {
              "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": 0.46
            },
            {
              "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": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 1.69,
              "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": 1.69,
              "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": 1.69,
              "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": 1.69,
              "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": 1.69,
              "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": 0.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 1.69,
              "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": 0.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.69,
              "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": 1.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.39
            },
            {
              "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": 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": 1.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.44
            },
            {
              "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": 1.69,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Direct Coombs Dat",
      "code_information": [
        {
          "code": "PX-30200536",
          "type": "CDM"
        },
        {
          "code": "86880",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 200,
          "discounted_cash": 130,
          "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": 128.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 128.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 146
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 126.4
            },
            {
              "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": 175.4
            },
            {
              "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": 200,
              "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": 111
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.39,
              "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": 53.92,
              "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": 128.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 130.2
            },
            {
              "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": 161.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 111
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 110
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "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": 164
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 128.4
            },
            {
              "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": 130.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 126.4
            },
            {
              "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": 110
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 110
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 146
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.85,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.92,
              "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": 126.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 126.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 164
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 150
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 111
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "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": 54.48,
              "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": 53.92,
              "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": 126.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 128.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 110
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "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": 164
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 175.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 165.8
            },
            {
              "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": 200,
              "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": 128.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 164
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 111
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 165.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 110
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.85,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 110
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 150
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 128.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 146
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 126.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "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": 54.48,
              "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": 170
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 146
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 164
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.06,
              "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": 146
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 161.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 150
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.39,
              "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": 56.06,
              "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": 128.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 200,
              "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": 200
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 126.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "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": 128.4
            },
            {
              "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": 128.4
            },
            {
              "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": 128.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 130.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "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": 54.48,
              "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": 170
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 164
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.06,
              "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": 53.92,
              "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": 165.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 126.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 128.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 130.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 146
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 176
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 110
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.92,
              "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": 164
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.85,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 130
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 130.2
            },
            {
              "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": 164
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.39,
              "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": 54.6
            },
            {
              "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": 53.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.21,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 170
            }
          ],
          "minimum": 7.85,
          "maximum": 20.21
        }
      ]
    },
    {
      "description": "HC Hepatitis B Surface Antigen",
      "code_information": [
        {
          "code": "PX-30200547",
          "type": "CDM"
        },
        {
          "code": "87340",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 31,
          "discounted_cash": 20.15,
          "minimum": 8.86,
          "maximum": 38.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.86,
              "estimated_amount": 8.86
            },
            {
              "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": "MOLINA 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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 13.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.33,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "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": 17.05
            },
            {
              "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": 26.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.86,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "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": 13.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.33,
              "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": 17.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.33,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.33,
              "estimated_amount": 10.33
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "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": 13.95
            },
            {
              "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "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": 22.63
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.33,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.86,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.33,
              "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": 23.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "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": 27.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.43,
              "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": 50,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "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": "HUMANA [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": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.86,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "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": "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": "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": "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 STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.59,
              "estimated_amount": 13.59
            },
            {
              "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": 7.75
            },
            {
              "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.33,
              "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": 26.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.59,
              "estimated_amount": 13.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.85,
              "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": 25.42
            },
            {
              "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": 25.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.63
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 13.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "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": 13.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 13.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 13.95
            },
            {
              "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": 15.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.85,
              "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": 45,
              "estimated_amount": 13.95
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.59,
              "estimated_amount": 13.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.43,
              "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": 45,
              "estimated_amount": 13.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 13.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 15.5
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 10.33,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.85,
              "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": 31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.74,
              "estimated_amount": 38.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            }
          ]
        }
      ]
    },
    {
      "description": "Rotavirus Antigen Feces Sendout",
      "code_information": [
        {
          "code": "PX-30200556",
          "type": "CDM"
        },
        {
          "code": "87425",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 105,
          "discounted_cash": 68.25,
          "minimum": 10.28,
          "maximum": 44.93,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 52.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "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": 92.4
            },
            {
              "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": 86.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.65
            },
            {
              "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": 89.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "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": 78.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 52.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 52.5
            },
            {
              "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": 52.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 52.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 47.25
            },
            {
              "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": 68.25
            },
            {
              "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": 105,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.75
            },
            {
              "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": 47.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.53,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.58,
              "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": 45,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.1,
              "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": 45,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.75
            },
            {
              "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": 47.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.1,
              "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": 89.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 105
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.98,
              "estimated_amount": 11.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 52.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.98,
              "estimated_amount": 11.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "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": 86.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.53,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.1,
              "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": 50,
              "estimated_amount": 52.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "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": 105,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.58,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.98,
              "estimated_amount": 11.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 47.25
            },
            {
              "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": 76.65
            },
            {
              "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": 89.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "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": 52.5
            },
            {
              "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": 86.1
            },
            {
              "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": 57.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.98,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.58,
              "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": 50,
              "estimated_amount": 52.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.98,
              "estimated_amount": 11.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.98,
              "estimated_amount": 11.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.98,
              "estimated_amount": 11.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 105,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.53,
              "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": 89.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 52.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": 26.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.98,
              "estimated_amount": 11.98
            },
            {
              "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": 47.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            }
          ]
        }
      ]
    },
    {
      "description": "HC Wbc Count Auto",
      "code_information": [
        {
          "code": "PX-30500014",
          "type": "CDM"
        },
        {
          "code": "85048",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 48,
          "discounted_cash": 31.2,
          "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": 30.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "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": 26.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.82
            },
            {
              "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": 40.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.72,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.57,
              "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": 30.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.4
            },
            {
              "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": 39.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.72,
              "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": 30.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "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": 31.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.72,
              "estimated_amount": 3.72
            },
            {
              "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": 30.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.54,
              "estimated_amount": 2.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.54,
              "estimated_amount": 2.54
            },
            {
              "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": 48,
              "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": 30.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.54,
              "estimated_amount": 2.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "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": 30.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.57,
              "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": 30.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 39.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "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": 30.82
            },
            {
              "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": 38.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.54,
              "estimated_amount": 2.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "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": 40.8
            },
            {
              "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": 39.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.67,
              "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": 39.79
            },
            {
              "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": 42.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.67,
              "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": 30.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "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": 26.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "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": 31.25
            },
            {
              "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": 39.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.36
            },
            {
              "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": 26.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.57,
              "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": 40.8
            },
            {
              "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": 30.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.54,
              "estimated_amount": 2.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.53,
              "estimated_amount": 9.53
            },
            {
              "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": 26.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.54,
              "estimated_amount": 2.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.25
            },
            {
              "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": 31.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 35.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.57,
              "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": 40.8
            },
            {
              "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": 42.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 26.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 2.54,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.57,
              "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": 30.34
            },
            {
              "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": 42.1
            },
            {
              "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": 13.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.54,
              "estimated_amount": 2.54
            },
            {
              "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": 48,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 2.54,
          "maximum": 9.53
        }
      ]
    },
    {
      "description": "Factor 8 Vonwillebrand Multimetric Sendout",
      "code_information": [
        {
          "code": "PX-30500025",
          "type": "CDM"
        },
        {
          "code": "85247",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 175,
          "discounted_cash": 113.75,
          "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": 112.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 154
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 97.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 131.25
            },
            {
              "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": 112.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 97.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 175
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 97.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "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": 110.6
            },
            {
              "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": 113.75
            },
            {
              "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": 112.35
            },
            {
              "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": 112.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 113.93
            },
            {
              "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": 153.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 131.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "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": 113.93
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "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": 148.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "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": 143.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "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": 141.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 47.78
            },
            {
              "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": 148.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 145.08
            },
            {
              "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": 143.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 113.93
            },
            {
              "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": 110.6
            },
            {
              "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": 110.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "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": 127.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 143.5
            },
            {
              "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": 97.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "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": 96.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "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": 143.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 148.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 141.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 131.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "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": 127.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "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": 113.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "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": 112.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "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": 148.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 113.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "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": 112.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "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": 153.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 22.94,
          "maximum": 86.03
        }
      ]
    },
    {
      "description": "HC Ristocetin Cofactor Assay",
      "code_information": [
        {
          "code": "PX-30500085",
          "type": "CDM"
        },
        {
          "code": "85245",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2929,
          "discounted_cash": 1903.85,
          "minimum": 18.16,
          "maximum": 86.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1464.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 2489.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2196.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1464.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2138.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 2489.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1610.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1318.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1464.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "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": 2929,
              "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": 1610.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "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": 2929,
              "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": 1610.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2138.17
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1318.05
            },
            {
              "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": 1318.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1610.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "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": 732.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2401.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "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": 2138.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2196.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1610.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1610.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2138.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "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": 2401.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2929
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1464.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1318.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "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": 2577.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 1903.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2401.78
            },
            {
              "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": 2401.78
            },
            {
              "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": 641.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 2929,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "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": 50,
              "estimated_amount": 1464.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1464.5
            },
            {
              "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": 1464.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "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": 2489.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1318.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1318.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2401.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1318.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1464.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2401.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1610.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "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": 2401.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1318.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "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": 1318.05
            },
            {
              "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": 1318.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2489.65
            },
            {
              "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": 1464.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2401.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1464.5
            },
            {
              "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": 2489.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2138.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2196.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2138.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fungi Identification Mold So",
      "code_information": [
        {
          "code": "PX-30600091",
          "type": "CDM"
        },
        {
          "code": "87107",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 147,
          "discounted_cash": 95.55,
          "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": 94.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.09,
              "estimated_amount": 15.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "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": 94.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "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": 95.7
            },
            {
              "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": 92.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "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": 95.55
            },
            {
              "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": 129.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 147
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "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": 94.37
            },
            {
              "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": 95.7
            },
            {
              "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": 120.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "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": 92.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "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": 94.37
            },
            {
              "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": 120.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "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": 124.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.86
            },
            {
              "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": 94.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "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": 81.59
            },
            {
              "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": 124.95
            },
            {
              "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": 147,
              "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": 94.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "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": 92.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 81.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.09,
              "estimated_amount": 15.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 118.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.25
            },
            {
              "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": 94.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "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": 121.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "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": 80.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "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": 128.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "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": 118.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "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": 40.13
            },
            {
              "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": 120.54
            },
            {
              "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": 81.59
            },
            {
              "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": 81.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.25
            },
            {
              "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": 107.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "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": 147,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "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": 147,
              "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": 107.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.7,
              "estimated_amount": 38.7
            },
            {
              "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": 128.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            }
          ],
          "minimum": 15.09,
          "maximum": 38.7
        }
      ]
    },
    {
      "description": "HC Culture Typing Serologic",
      "code_information": [
        {
          "code": "PX-30600124",
          "type": "CDM"
        },
        {
          "code": "87147",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 151,
          "discounted_cash": 98.15,
          "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": 96.94
            },
            {
              "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": 96.94
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.05
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 132.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.43
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.05
            },
            {
              "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": 83.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.18
            },
            {
              "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": 95.43
            },
            {
              "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": 83.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.82
            },
            {
              "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": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.05
            },
            {
              "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": 83.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.43
            },
            {
              "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": 132.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.94
            },
            {
              "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": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 132.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 83.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.66,
              "estimated_amount": 6.66
            },
            {
              "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": 96.94
            },
            {
              "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": 123.82
            },
            {
              "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 OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "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": 98.15
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "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": 83.81
            },
            {
              "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": 151,
              "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": 96.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 151
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 123.82
            },
            {
              "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": 96.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.23
            },
            {
              "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": 128.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.66,
              "estimated_amount": 6.66
            },
            {
              "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": "MOLINA 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,
              "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": 96.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 83.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.43
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.66,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 122.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 110.23
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.94
            },
            {
              "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": 123.82
            },
            {
              "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": 123.82
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": 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": 110.23
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.43
            },
            {
              "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": 98.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.82
            },
            {
              "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": 41.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.94
            },
            {
              "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": 122.16
            },
            {
              "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": 98.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "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": 151,
              "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": 123.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.35
            },
            {
              "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": 125.18
            }
          ],
          "minimum": 5.18,
          "maximum": 19.43
        }
      ]
    },
    {
      "description": "Lyme Disease by Pcr Sendout",
      "code_information": [
        {
          "code": "PX-30600189",
          "type": "CDM"
        },
        {
          "code": "87476",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 247,
          "discounted_cash": 160.55,
          "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": 158.57
            },
            {
              "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": 158.57
            },
            {
              "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": 158.57
            },
            {
              "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": 137.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "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": 202.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 180.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 180.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 35.09,
              "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": 204.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "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": 158.57
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "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": 185.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 160.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 202.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 137.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 199.82
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 216.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 247,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 158.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 180.31
            },
            {
              "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": 156.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 160.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 202.54
            },
            {
              "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": 180.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 158.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 158.57
            },
            {
              "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": 199.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 158.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 158.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 202.54
            },
            {
              "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": 156.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 67.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 209.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 137.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 204.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 160.8
            },
            {
              "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": 209.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 247
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 158.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 247,
              "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": 160.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 204.76
            },
            {
              "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": 135.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 158.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 158.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "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": 137.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 185.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 180.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 180.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "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": 160.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "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": 202.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 202.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 185.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 160.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 216.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.85
            },
            {
              "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": 202.54
            },
            {
              "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": 247,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 217.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 156.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 202.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.95
            }
          ],
          "minimum": 35.09,
          "maximum": 131.59
        }
      ]
    },
    {
      "description": "HC C Difficile Toxin Pcr",
      "code_information": [
        {
          "code": "PX-30600198",
          "type": "CDM"
        },
        {
          "code": "87493",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 229,
          "discounted_cash": 148.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 143.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "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": 187.78
            },
            {
              "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": 194.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 143.13
            },
            {
              "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": 114.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 103.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171.75
            },
            {
              "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": 143.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "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": 194.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 103.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.27,
              "estimated_amount": 37.27
            },
            {
              "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": 143.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.27,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 143.13
            },
            {
              "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": 103.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.1,
              "estimated_amount": 30.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 167.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "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": 125.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.27,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 167.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 103.05
            },
            {
              "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": 201.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.1,
              "estimated_amount": 30.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 143.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 167.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "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": 229,
              "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": 50,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 167.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.64,
              "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": 125.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.1,
              "estimated_amount": 30.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.1,
              "estimated_amount": 30.1
            },
            {
              "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": 62.5,
              "estimated_amount": 143.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 114.5
            },
            {
              "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": 187.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 103.05
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.95,
              "estimated_amount": 49.95
            },
            {
              "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": 103.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.27,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.95,
              "estimated_amount": 49.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.27,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 114.5
            },
            {
              "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": 187.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.64,
              "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": 62.5,
              "estimated_amount": 143.13
            },
            {
              "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": 143.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 103.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "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": 229,
              "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": 171.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 114.5
            },
            {
              "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": 57.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "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": 148.85
            },
            {
              "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": 143.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.13,
              "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": 50,
              "estimated_amount": 114.5
            },
            {
              "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": 103.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 143.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 229
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.27,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.95,
              "estimated_amount": 49.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 37.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.64,
              "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": 45,
              "estimated_amount": 103.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 103.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 139.76,
              "estimated_amount": 139.76
            },
            {
              "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": 167.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 143.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.27,
              "estimated_amount": 37.27
            },
            {
              "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": 229,
              "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": 167.17
            }
          ],
          "minimum": 30.1,
          "maximum": 139.76
        }
      ]
    },
    {
      "description": "HC Chrom Anlys Addl Cell CT Ea Stdy So",
      "code_information": [
        {
          "code": "PX-31000033",
          "type": "CDM"
        },
        {
          "code": "88285",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 275,
          "discounted_cash": 178.75,
          "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": 176.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.03
            },
            {
              "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": 225.5
            },
            {
              "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": 233.75
            },
            {
              "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": 173.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 227.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 206.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "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": 242
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.18,
              "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": 173.8
            },
            {
              "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": 225.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.18,
              "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": 275,
              "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": 200.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "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": 233.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.91,
              "estimated_amount": 26.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.75
            },
            {
              "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": 176.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.5
            },
            {
              "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": 241.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.18,
              "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": 152.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "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": 225.5
            },
            {
              "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": 75.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.55
            },
            {
              "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": 222.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.75
            },
            {
              "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": 275,
              "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": 179.03
            },
            {
              "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": 173.8
            },
            {
              "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": 275,
              "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": 176.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.26,
              "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": 233.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.5
            },
            {
              "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": 176.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.55
            },
            {
              "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": 179.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.25
            },
            {
              "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": 227.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 206.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.91,
              "estimated_amount": 26.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 275
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 152.63
            },
            {
              "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": 200.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.76,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.26,
              "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": 176.55
            },
            {
              "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": 241.18
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.76,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 26.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.18,
              "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": 26.91,
              "estimated_amount": 26.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 227.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.76,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.91,
              "estimated_amount": 26.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.91,
              "estimated_amount": 26.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.91,
              "estimated_amount": 26.91
            },
            {
              "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": 173.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "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": 178.75
            },
            {
              "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": 152.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 152.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 206.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 222.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.91,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.91,
              "estimated_amount": 26.91
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.75
            },
            {
              "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": 176.55
            }
          ],
          "minimum": 26.91,
          "maximum": 100.91
        }
      ]
    },
    {
      "description": "HC Gross and Micro Level II 1 Spec",
      "code_information": [
        {
          "code": "PX-31000039",
          "type": "CDM"
        },
        {
          "code": "88302",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 520,
          "discounted_cash": 338,
          "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": 333.84
            },
            {
              "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": 141.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 456.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 379.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 333.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26.25,
              "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": 63.2,
              "estimated_amount": 328.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 333.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.4
            },
            {
              "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": 426.4
            },
            {
              "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": 26.25,
              "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": 333.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 25.99,
              "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": 379.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 520
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 333.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 328.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 379.6
            },
            {
              "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": 26.52,
              "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
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 457.6
            },
            {
              "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": 333.84
            },
            {
              "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": 520,
              "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": 390
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 426.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 333.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26.52,
              "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": 338.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 328.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 520,
              "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": 333.84
            },
            {
              "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": 338.52
            },
            {
              "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": 328.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 431.08
            },
            {
              "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": 431.08
            },
            {
              "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": 379.6
            },
            {
              "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": 27.29,
              "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": 426.4
            },
            {
              "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": 456.04
            },
            {
              "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": 26.52,
              "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": 27.29,
              "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": 25.99,
              "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": 286
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26.25,
              "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": 442
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 333.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 338.52
            },
            {
              "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": 442
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "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": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 333.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 338.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 333.84
            },
            {
              "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": 338.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 420.68
            },
            {
              "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": 288.6
            },
            {
              "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": 25.99,
              "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": 328.64
            },
            {
              "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": 520,
              "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": 328.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 420.68
            },
            {
              "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": 27.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 328.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 328.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 379.6
            },
            {
              "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": 288.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 288.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 431.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.48,
              "estimated_amount": 17.48
            },
            {
              "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": 26.25,
              "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": 426.4
            },
            {
              "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": 25.99,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.48,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            },
            {
              "payer_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
            },
            {
              "payer_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
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 379.6
            },
            {
              "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": 26.25,
              "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": 288.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 333.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442
            }
          ],
          "minimum": 17.48,
          "maximum": 93.6
        }
      ]
    },
    {
      "description": "HC Special Stain II",
      "code_information": [
        {
          "code": "PX-31000070",
          "type": "CDM"
        },
        {
          "code": "88313",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 541,
          "discounted_cash": 351.65,
          "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": 347.32
            },
            {
              "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": 443.62
            },
            {
              "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": 35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 443.62
            },
            {
              "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": 459.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297.55
            },
            {
              "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": 347.32
            },
            {
              "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": 347.32
            },
            {
              "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": 147.69
            },
            {
              "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": 300.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.91
            },
            {
              "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": 474.46
            },
            {
              "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": 347.32
            },
            {
              "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": 541,
              "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": 459.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 352.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.91
            },
            {
              "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": 300.26
            },
            {
              "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": 541,
              "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": 351.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 347.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 347.32
            },
            {
              "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": 352.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 347.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 448.49
            },
            {
              "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": 443.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 541
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 448.49
            },
            {
              "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": 341.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 352.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "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": 35.35,
              "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": 459.85
            },
            {
              "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": 36.75,
              "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,
              "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": 35.72,
              "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": 448.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 405.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.91
            },
            {
              "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": 341.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 347.32
            },
            {
              "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": 347.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.93
            },
            {
              "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": 474.46
            },
            {
              "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": 352.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.06,
              "estimated_amount": 23.06
            },
            {
              "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": 459.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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,
              "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": 347.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 405.75
            },
            {
              "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": 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": 35.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.06,
              "estimated_amount": 23.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 300.26
            },
            {
              "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": 36.75,
              "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": 35.35,
              "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": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 352.19
            },
            {
              "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": 443.62
            },
            {
              "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": 36.75,
              "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": 459.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 437.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 443.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.93
            },
            {
              "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": 35.35,
              "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": 341.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 347.32
            },
            {
              "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": 35.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "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": 297.55
            },
            {
              "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": 394.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 443.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 405.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.91
            },
            {
              "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": 35.72,
              "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": 437.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 443.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 443.62
            },
            {
              "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": 300.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 347.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "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": 35.72,
              "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": 476.08
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.06,
              "estimated_amount": 23.06
            },
            {
              "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": 541,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 23.06,
          "maximum": 127.35
        }
      ]
    },
    {
      "description": "HC Histochemistry Stain Esterase",
      "code_information": [
        {
          "code": "PX-31000080",
          "type": "CDM"
        },
        {
          "code": "88319",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 785,
          "discounted_cash": 510.25,
          "minimum": 47.15,
          "maximum": 2911.91,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "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": 643.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 573.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 785,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "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": 510.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "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": 750.49,
              "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": 667.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 643.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 785,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 750.49,
              "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": 750.49,
              "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": 431.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "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": 765.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 643.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 588.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 643.7
            },
            {
              "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": 750.49,
              "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": 588.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 588.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 431.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 573.05
            },
            {
              "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": 788.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 750.49,
              "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": 758,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.15,
              "estimated_amount": 47.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 431.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 785,
              "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": 785,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.15,
              "estimated_amount": 47.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "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": 758,
              "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": 788.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "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": 788.02,
              "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": 667.25
            },
            {
              "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": 785,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 765.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.9,
              "estimated_amount": 49.9
            },
            {
              "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": 667.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 431.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.65,
              "estimated_amount": 104.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 643.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 431.75
            },
            {
              "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": 750.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 643.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 573.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.65,
              "estimated_amount": 104.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 643.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 573.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.15,
              "estimated_amount": 47.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.9,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "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": 758,
              "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": 431.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 573.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "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": 643.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "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": 196.25
            },
            {
              "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": 667.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 667.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 198.7,
              "estimated_amount": 198.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.9,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.9,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 785,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 690.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 758,
              "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": 758,
              "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": 765.81,
              "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": 785
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 431.75
            },
            {
              "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": 573.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 785,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": 785,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.81,
              "estimated_amount": 56.81
            }
          ]
        }
      ]
    },
    {
      "description": "HC Flow Cytometry Marker Tc Ea Addl",
      "code_information": [
        {
          "code": "PX-31100016",
          "type": "CDM"
        },
        {
          "code": "88185",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 145,
          "discounted_cash": 94.25,
          "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": 93.09
            },
            {
              "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": 79.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "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": 93.09
            },
            {
              "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": 117.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "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": 105.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 145,
              "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": 145,
              "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": 91.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 118.9
            },
            {
              "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": 145,
              "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": 127.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 80.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "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": 145,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 93.09
            },
            {
              "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": 145,
              "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": 79.75
            },
            {
              "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": 127.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 118.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 145,
              "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": 79.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "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": 94.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 127.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "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": 80.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 145
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "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": 145,
              "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": 91.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "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": 145,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.62,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 80.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 120.21
            },
            {
              "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": 123.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 145,
              "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": 145,
              "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": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "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": 145,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "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": 145,
              "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": 123.25
            },
            {
              "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": 145,
              "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": 120.21
            },
            {
              "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": 91.64
            },
            {
              "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": 118.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 145,
              "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": 145,
              "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": 145,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.62,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 117.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "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": 94.25
            },
            {
              "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": 145,
              "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": 94.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.62,
              "estimated_amount": 25.62
            },
            {
              "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": 39.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "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": 91.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.23,
              "estimated_amount": 90.23
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 120.21
            },
            {
              "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": 145,
              "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": 80.48
            }
          ],
          "minimum": 25.62,
          "maximum": 90.23
        }
      ]
    },
    {
      "description": "HC Xr Knee 1 or 2 Vw",
      "code_information": [
        {
          "code": "PX-32000086",
          "type": "CDM"
        },
        {
          "code": "73560",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 312,
          "discounted_cash": 202.8,
          "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": 200.3
            },
            {
              "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": 200.3
            },
            {
              "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": 200.3
            },
            {
              "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": 197.18
            },
            {
              "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": 173.16
            },
            {
              "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.3
            },
            {
              "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": 85.18
            },
            {
              "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": 273.62
            },
            {
              "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": "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": "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": "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": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.3
            },
            {
              "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": 80.93,
              "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": 312,
              "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": 252.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 312,
              "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": 203.11
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.93,
              "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": 312,
              "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": 79.31,
              "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": 234
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "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": 227.76
            },
            {
              "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": 83.28,
              "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": 274.56
            },
            {
              "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 234
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.28,
              "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": 273.62
            },
            {
              "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": 312,
              "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": 171.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.18
            },
            {
              "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": 80.93,
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 312
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "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": 80.1,
              "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": 203.11
            },
            {
              "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": 197.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 202.8
            },
            {
              "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": 80.1,
              "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": 197.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 312,
              "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": 255.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.3
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "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": 80.1,
              "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": 265.2
            },
            {
              "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": 79.31,
              "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": 171.6
            },
            {
              "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.3
            },
            {
              "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": 255.84
            },
            {
              "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": 83.28,
              "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": 312,
              "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": 258.65
            },
            {
              "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": 312,
              "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": 258.65
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "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": 265.2
            },
            {
              "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": 200.3
            },
            {
              "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": 255.84
            },
            {
              "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 OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 258.65
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 265.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 227.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 265.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 265.2
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 80.1,
              "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": 312,
              "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": 312,
              "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": 312,
              "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": 227.76
            },
            {
              "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": 200.3
            },
            {
              "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": "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": "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 312,
              "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": 312,
              "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": 197.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 312,
              "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": 203.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.18
            },
            {
              "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": 80.1,
              "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"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Lower Extremity Infant 2 + Vw",
      "code_information": [
        {
          "code": "PX-32000092",
          "type": "CDM"
        },
        {
          "code": "73592",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 289,
          "discounted_cash": 187.85,
          "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": 185.54
            },
            {
              "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": 185.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 185.54
            },
            {
              "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": 83.28,
              "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": 289,
              "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": 289
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 185.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 210.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.1,
              "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": 188.14
            },
            {
              "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": 83.15,
              "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": 84.84,
              "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": 188.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 182.65
            },
            {
              "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": 84.84,
              "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": 245.65
            },
            {
              "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": 80.1,
              "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": 160.4
            },
            {
              "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": 245.65
            },
            {
              "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": 78.9
            },
            {
              "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": 160.4
            },
            {
              "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": 158.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 210.97
            },
            {
              "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": 236.98
            },
            {
              "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": 182.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 187.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 236.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 289,
              "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": 245.65
            },
            {
              "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": 83.15,
              "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": 158.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 289,
              "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": 245.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 185.54
            },
            {
              "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": 182.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 182.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 236.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 289,
              "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": 245.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.95
            },
            {
              "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": 185.54
            },
            {
              "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": 160.4
            },
            {
              "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": 239.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 245.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 239.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 216.75
            },
            {
              "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": 210.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 245.65
            },
            {
              "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": 289,
              "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": 289,
              "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": 289,
              "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": 185.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 236.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 236.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 216.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 182.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 239.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 158.95
            },
            {
              "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": 83.28,
              "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": 185.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 245.65
            },
            {
              "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": 83.15,
              "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": 210.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 160.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 84.84,
              "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": 254.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 233.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 188.14
            },
            {
              "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": 83.15,
              "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": 210.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 185.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 182.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 182.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 289,
              "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": 289,
              "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": 289,
              "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": 185.54
            },
            {
              "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": 87.3,
              "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": 245.65
            },
            {
              "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": 80.1,
              "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": 289,
              "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": 253.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 245.65
            },
            {
              "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": 185.54
            },
            {
              "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": 182.65
            },
            {
              "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": 289,
              "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": 236.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 245.65
            },
            {
              "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": 236.98
            },
            {
              "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": 233.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 245.65
            },
            {
              "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": 253.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 289,
              "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": 80.1,
              "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": 80.1,
              "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": 289,
              "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": 245.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 216.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 210.97
            },
            {
              "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": 245.65
            },
            {
              "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": 185.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 188.14
            },
            {
              "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": 188.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 289,
              "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": 236.98
            }
          ]
        }
      ]
    },
    {
      "description": "HC Remove FB Esophagus W Balloon Cath",
      "code_information": [
        {
          "code": "PX-32000107",
          "type": "CDM"
        },
        {
          "code": "74235",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 994,
          "discounted_cash": 646.1,
          "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": 638.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 815.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 628.21
            },
            {
              "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": 874.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 824.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 647.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 725.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 638.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 551.67
            },
            {
              "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": 871.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 546.7
            },
            {
              "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": 628.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 638.15
            },
            {
              "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": 994,
              "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": 638.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 638.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 815.08
            },
            {
              "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": 628.21
            },
            {
              "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": 725.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 844.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 638.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 647.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 815.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 844.9
            },
            {
              "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": 647.09
            },
            {
              "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": 638.15
            },
            {
              "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": 638.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 725.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 725.62
            },
            {
              "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": 844.9
            },
            {
              "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": 628.21
            },
            {
              "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": 638.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 994
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 994,
              "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": 994,
              "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": 815.08
            },
            {
              "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": 271.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 844.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 994,
              "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": 994,
              "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": 994,
              "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": 546.7
            },
            {
              "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": 815.08
            },
            {
              "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": 815.08
            },
            {
              "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": 871.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 804.15
            },
            {
              "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": 815.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 647.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 824.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 844.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 546.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 994,
              "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": 628.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 994,
              "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": 638.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 745.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 804.15
            },
            {
              "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": 844.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 815.08
            },
            {
              "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": 994,
              "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": 725.62
            },
            {
              "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": 824.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 546.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 844.9
            },
            {
              "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": 647.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 844.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 745.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 844.9
            },
            {
              "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": 646.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 745.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 628.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 546.7
            },
            {
              "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": 551.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 546.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 725.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 546.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 628.21
            },
            {
              "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": 551.67
            },
            {
              "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": 551.67
            },
            {
              "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": 638.15
            },
            {
              "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": 994,
              "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": 994,
              "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": 994,
              "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": 844.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 628.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 844.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 994,
              "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": 638.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 844.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC Portogram W Hemodynamics",
      "code_information": [
        {
          "code": "PX-32000162",
          "type": "CDM"
        },
        {
          "code": "75885",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4458,
          "discounted_cash": 2897.7,
          "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": 2862.04
            },
            {
              "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": 2921.09,
              "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": 3343.5
            },
            {
              "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": 3254.34
            },
            {
              "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": 2838.77,
              "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": 2451.9
            },
            {
              "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": 3789.3
            },
            {
              "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": 2902.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 2781.99,
              "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": 2817.46
            },
            {
              "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": 3789.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 3909.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2474.19
            },
            {
              "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": 2474.19
            },
            {
              "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": 2838.77,
              "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": 4458,
              "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": 4458,
              "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": 3923.04
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 2809.81,
              "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": 2862.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3606.52
            },
            {
              "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": 4458,
              "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": 4458,
              "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": 4458,
              "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": 2781.99,
              "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": 3789.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 976.3
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2451.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 2862.04
            },
            {
              "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": 4458,
              "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": 2862.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "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": 2474.19
            },
            {
              "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": 2809.81,
              "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": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2862.04
            },
            {
              "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": 1217.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 2781.99,
              "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": 2921.09,
              "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": 3695.68
            },
            {
              "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": 3909.67
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2902.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3695.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 3254.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 4458,
              "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": 2451.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "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": 3695.68
            },
            {
              "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": 4458,
              "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": 2862.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2897.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2474.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "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": 2817.46
            },
            {
              "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": 2781.99,
              "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": 4458,
              "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": 4458,
              "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": 4458,
              "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": 2451.9
            },
            {
              "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": 2921.09,
              "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": 4458,
              "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": 4458,
              "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": 4458
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2862.04
            },
            {
              "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": 3606.52
            },
            {
              "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": 2902.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "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": 3655.56
            },
            {
              "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": 2838.77,
              "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": 3254.34
            },
            {
              "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": 2809.81,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Transcath Therapy Embolization",
      "code_information": [
        {
          "code": "PX-32000167",
          "type": "CDM"
        },
        {
          "code": "75894",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2539,
          "discounted_cash": 1650.35,
          "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": 1630.04
            },
            {
              "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": 2539,
              "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": 2158.15
            },
            {
              "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": 1409.15
            },
            {
              "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": 2539,
              "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": 1652.89
            },
            {
              "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": 1409.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2539
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1853.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1604.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1630.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2081.98
            },
            {
              "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": 2539,
              "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": 2539,
              "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": 1630.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1853.47
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2539,
              "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": 2539,
              "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": 2104.83
            },
            {
              "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": 2539,
              "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": 2054.05
            },
            {
              "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": 2234.32
            },
            {
              "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": 1650.35
            },
            {
              "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": 2158.15
            },
            {
              "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": 2539,
              "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": 1652.89
            },
            {
              "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": 1630.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1652.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2539,
              "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": 2158.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1396.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2539,
              "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": 2539,
              "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": 1904.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1396.45
            },
            {
              "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": 2539,
              "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": 2539,
              "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": 2081.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1396.45
            },
            {
              "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": 1604.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 2158.15
            },
            {
              "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": 1630.04
            },
            {
              "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": 1652.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 2539,
              "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": 1853.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1396.45
            },
            {
              "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": 2539,
              "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": 2081.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1604.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1396.45
            },
            {
              "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": 2226.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 1630.04
            },
            {
              "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": 693.15
            },
            {
              "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": 2539,
              "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": 2539,
              "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": 1853.47
            },
            {
              "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": 2539,
              "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": 2081.98
            },
            {
              "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": 1604.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1604.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1904.25
            },
            {
              "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": 2539,
              "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": 1652.89
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2539,
              "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": 2539,
              "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": 2081.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 1904.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1630.04
            },
            {
              "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": 2539,
              "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": 1604.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 2539,
              "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": 2539,
              "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": 2539,
              "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": 2539,
              "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": 2081.98
            },
            {
              "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": 2539,
              "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": 2226.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "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": 2539,
              "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": 556.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2104.83
            },
            {
              "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": 1396.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1853.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "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": 2104.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 2081.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1604.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1630.04
            },
            {
              "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": 1630.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1630.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 1853.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1630.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2054.05
            },
            {
              "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": 2081.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2158.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1409.15
            },
            {
              "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": 1409.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "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": 1604.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1396.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1630.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2539,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Ercp Biliary Ductal System Only",
      "code_information": [
        {
          "code": "PX-32000220",
          "type": "CDM"
        },
        {
          "code": "74328",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 596,
          "discounted_cash": 387.4,
          "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": 382.63
            },
            {
              "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": 488.72
            },
            {
              "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": 488.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "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": 376.67
            },
            {
              "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": 330.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 327.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 327.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 330.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 494.08
            },
            {
              "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": 506.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 488.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 494.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 596,
              "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": 382.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 382.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 596,
              "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": 596,
              "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": 387.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 488.72
            },
            {
              "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": 596,
              "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": 376.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "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": 330.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 327.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "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": 488.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 376.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 388
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 482.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 488.72
            },
            {
              "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": 327.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "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": 388
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 382.63
            },
            {
              "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": 162.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 376.67
            },
            {
              "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": 522.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 376.67
            },
            {
              "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": 376.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 376.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 382.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 447
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 596,
              "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": 327.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 382.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 596,
              "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": 388
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 382.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 482.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 447
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 435.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 435.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 382.63
            },
            {
              "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": 382.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 435.08
            },
            {
              "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": 435.08
            },
            {
              "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": 596,
              "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": 330.78
            },
            {
              "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": 596,
              "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": 522.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 596,
              "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": 382.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 388
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 435.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 327.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 382.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 327.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 506.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 488.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 494.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 435.08
            },
            {
              "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": 506.6
            },
            {
              "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": 382.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 488.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 376.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 524.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 596
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 596,
              "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": 506.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 388
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 447
            }
          ]
        }
      ]
    },
    {
      "description": "HC Chemo Admin Cns W Lp",
      "code_information": [
        {
          "code": "PX-33100007",
          "type": "CDM"
        },
        {
          "code": "96450",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2531,
          "discounted_cash": 1645.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1624.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1647.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1392.05
            },
            {
              "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": 1392.05
            },
            {
              "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": 2227.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "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": 301.62,
              "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": 1624.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1847.63
            },
            {
              "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": 2075.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1599.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 1647.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2075.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 2531,
              "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": 1624.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1624.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2075.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "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": 295.58,
              "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": 2098.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1404.71
            },
            {
              "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": 1624.9
            },
            {
              "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": 2075.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2098.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1898.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 1898.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1847.63
            },
            {
              "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": 1599.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1624.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2531
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2219.69
            },
            {
              "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": 2219.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2075.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1624.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2047.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 295.58,
              "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": 1599.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1847.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1392.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1847.63
            },
            {
              "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": 1404.71
            },
            {
              "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": 1624.9
            },
            {
              "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": 1847.63
            },
            {
              "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": 2531,
              "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": 1645.15
            },
            {
              "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": 298.54,
              "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": 2075.42
            },
            {
              "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": 310.36,
              "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": 1898.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2075.42
            },
            {
              "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": 310.36,
              "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": 2531,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 554.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1392.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1624.9
            },
            {
              "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": 2047.58
            },
            {
              "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": 690.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1599.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "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": 1624.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 2151.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 2531,
              "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": 2151.35
            },
            {
              "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": 2531,
              "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": 2531,
              "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": 2531,
              "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": 2098.2
            },
            {
              "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": 298.54,
              "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": 298.54,
              "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": 298.54,
              "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": 1599.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2531,
              "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": 1647.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1392.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 2531,
              "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": 2151.35
            },
            {
              "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": 295.58,
              "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": 2151.35
            },
            {
              "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": 2531,
              "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": 298.54,
              "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": 1624.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1624.9
            },
            {
              "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": 295.58,
              "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": 1404.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 2531,
              "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": 1847.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1599.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 1392.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1392.05
            },
            {
              "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": 301.62,
              "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": 2531,
              "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": 2075.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2531,
              "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": 301.62,
              "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": 1599.59
            },
            {
              "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": 1404.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1647.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2151.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1599.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1647.68
            },
            {
              "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": 2151.35
            },
            {
              "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": 310.36,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Nebulizer Full Kit 3cc Medication Delivery",
      "code_information": [
        {
          "code": "PX-CH-SA8900",
          "type": "CDM"
        },
        {
          "code": "A7003",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.47,
          "discounted_cash": 0.96,
          "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": 0.94
            },
            {
              "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": 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": 1.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "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": 0.96
            },
            {
              "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": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.47,
              "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": 1.47,
              "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": 1.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.47,
              "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": 0.81
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.93
            },
            {
              "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 HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "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": 1.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.25
            },
            {
              "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": 1.47,
              "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": 0.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 0.81
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.19
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.93
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.29
            },
            {
              "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": 0.81
            },
            {
              "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": 1.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.93
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.25
            },
            {
              "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": 0.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.25
            },
            {
              "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": 1.47,
              "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": 0.94
            },
            {
              "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 DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.82
            },
            {
              "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": 1.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.25
            },
            {
              "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": 0.82
            },
            {
              "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": 1.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.47,
              "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": "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": "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": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "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": 1.22
            },
            {
              "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": 1.47,
              "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": 1.1
            },
            {
              "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": 0.94
            },
            {
              "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": 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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.82
            },
            {
              "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": 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": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.47,
              "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": 0.81
            },
            {
              "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": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 1.47,
              "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": 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": 1.47,
              "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": 1.07
            },
            {
              "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": 1.19
            },
            {
              "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": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.47,
              "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": 0.4
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Uro Up to 4 1/3 in High Ouput",
      "code_information": [
        {
          "code": "PX-CH-HO80110",
          "type": "CDM"
        },
        {
          "code": "A6154",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.4,
          "discounted_cash": 8.71,
          "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": 8.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 10.05
            },
            {
              "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": 8.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 10.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 8.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 13.4,
              "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": 10.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 13.4,
              "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": 8.6
            },
            {
              "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": 11.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.37
            },
            {
              "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": 13.4,
              "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": 13.4,
              "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": 9.78
            },
            {
              "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": 10.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.39
            },
            {
              "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": 7.44
            },
            {
              "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": 13.4,
              "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": 8.6
            },
            {
              "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": 3.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 13.4,
              "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": 11.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.4,
              "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": 13.4,
              "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": 11.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 11.39
            },
            {
              "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": 13.4,
              "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": 8.6
            },
            {
              "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": 8.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.4
            },
            {
              "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": 13.4,
              "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": 9.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.39
            },
            {
              "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": 8.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.39
            },
            {
              "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": 7.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 8.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 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": 9.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.4,
              "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": 10.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.72
            },
            {
              "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": 10.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 13.4,
              "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": 11.39
            },
            {
              "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": 8.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 8.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 11.39
            },
            {
              "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": 13.4,
              "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": 13.4,
              "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": 13.4,
              "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": 13.4,
              "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": 8.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 13.4,
              "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": 7.37
            },
            {
              "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": 8.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.39
            },
            {
              "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": 13.4,
              "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": 11.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 11.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.78
            },
            {
              "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": 13.4,
              "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": 8.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 13.4,
              "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": 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": 7.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.47
            },
            {
              "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": 8.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 13.4,
              "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": 13.4,
              "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": 13.4,
              "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": 11.39
            },
            {
              "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": 8.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.44
            },
            {
              "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": 7.37
            },
            {
              "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": 13.4,
              "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": 10.84
            },
            {
              "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": 11.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.4,
              "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": 8.6
            }
          ]
        }
      ]
    },
    {
      "description": "HC Muga Multiple Studies Pre Post",
      "code_information": [
        {
          "code": "PX-34100079",
          "type": "CDM"
        },
        {
          "code": "78473",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2773,
          "discounted_cash": 1802.45,
          "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": 1780.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2357.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1752.54
            },
            {
              "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": 1752.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1780.27
            },
            {
              "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": 1539.02
            },
            {
              "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": 2431.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1752.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 2773,
              "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": 2357.05
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2773,
              "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": 1805.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 1525.15
            },
            {
              "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": 1802.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2357.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2079.75
            },
            {
              "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": 1780.27
            },
            {
              "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": 2273.86
            },
            {
              "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": 2773,
              "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": 2243.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2357.05
            },
            {
              "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": 1805.22
            },
            {
              "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": 1805.22
            },
            {
              "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": 757.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2024.29
            },
            {
              "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": 2431.92
            },
            {
              "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": 1780.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1525.15
            },
            {
              "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": 1525.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 2773,
              "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": 2357.05
            },
            {
              "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": 1780.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2273.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1525.15
            },
            {
              "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": 1752.54
            },
            {
              "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": 1752.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 1780.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 1780.27
            },
            {
              "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": 2243.36
            },
            {
              "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": 2024.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 2773,
              "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": 1780.27
            },
            {
              "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": 2273.86
            },
            {
              "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": 1539.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1525.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1525.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1780.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1805.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2357.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 2024.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2357.05
            },
            {
              "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": 2773,
              "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": 2773,
              "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": 1539.02
            },
            {
              "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": 2357.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2024.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2773
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1805.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 1539.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 2357.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2273.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2273.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2079.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1752.54
            },
            {
              "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": 2773,
              "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": 2357.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2079.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 2273.86
            },
            {
              "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": 2298.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2773,
              "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": 2440.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1752.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 1525.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1780.27
            },
            {
              "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": 2773,
              "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": 2357.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2298.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2298.82
            },
            {
              "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": 1780.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2024.29
            },
            {
              "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": 2273.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1752.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1780.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2273.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2773,
              "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": 2357.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2024.29
            }
          ]
        }
      ]
    },
    {
      "description": "HC CT Pelvis WO Contrast",
      "code_information": [
        {
          "code": "PX-35200015",
          "type": "CDM"
        },
        {
          "code": "72192",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1364,
          "discounted_cash": 886.6,
          "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": 1003.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1103.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1364,
              "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": 1364,
              "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": 1002.54
            },
            {
              "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": 1118.48
            },
            {
              "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": 1118.48
            },
            {
              "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": 96.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1130.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "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": 97.91,
              "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": 372.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 887.96
            },
            {
              "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": 1364,
              "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": 1118.48
            },
            {
              "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": 998.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1364,
              "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": 100.75,
              "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": 1023
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 887.96
            },
            {
              "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": 887.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 998.45
            },
            {
              "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": 1196.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 995.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1200.32
            },
            {
              "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": 298.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 995.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "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": 995.72
            },
            {
              "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": 100.75,
              "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": 73.2,
              "estimated_amount": 998.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 95.95,
              "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": 95.95,
              "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": 96.91,
              "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": 1364,
              "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": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 998.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1159.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1364,
              "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": 995.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 995.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 1103.48
            },
            {
              "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": 887.96
            },
            {
              "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": 96.91,
              "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": 1003.9
            },
            {
              "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": 1130.76
            },
            {
              "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": 998.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 1002.54
            },
            {
              "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": 95.95,
              "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": 1364,
              "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": 1159.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "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": 998.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 886.6
            },
            {
              "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": 1002.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 97.91,
              "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": 750.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 998.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1159.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 995.72
            },
            {
              "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": 95.95,
              "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": 1364,
              "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": 750.2
            },
            {
              "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": 96.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1002.54
            },
            {
              "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": 1003.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 100.75,
              "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": 1364,
              "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": 1364,
              "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": 1159.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 1364,
              "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": 1196.23
            },
            {
              "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": 1159.4
            },
            {
              "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": 1364,
              "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": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1023
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 998.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 97.91,
              "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": 73.6,
              "estimated_amount": 1003.9
            },
            {
              "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": 1003.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1023
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1159.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1364
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.91,
              "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": 1118.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1130.76
            }
          ]
        }
      ]
    },
    {
      "description": "HC Iadna Herpes Virus 6 Quant So",
      "code_information": [
        {
          "code": "PX-30600328",
          "type": "CDM"
        },
        {
          "code": "87533",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2038,
          "discounted_cash": 1324.7,
          "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": 1308.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "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": 1324.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1308.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1326.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1120.9
            },
            {
              "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": 1787.33
            },
            {
              "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": 1787.33
            },
            {
              "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": 1648.74
            },
            {
              "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": 556.37
            },
            {
              "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": 1487.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2038
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1308.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1487.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1120.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1308.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1288.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1648.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1120.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1120.9
            },
            {
              "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": 1288.02
            },
            {
              "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": 1308.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "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": 1671.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1671.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1308.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1671.16
            },
            {
              "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": 1131.09
            },
            {
              "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": 1288.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1487.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1308.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 59.43,
              "estimated_amount": 59.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "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": 1732.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1288.02
            },
            {
              "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": 2038,
              "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": 1288.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "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": 1326.74
            },
            {
              "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": 1131.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1487.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1528.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1528.5
            },
            {
              "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": 1288.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1689.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1732.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1308.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1671.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1671.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "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": 1793.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1528.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1326.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1487.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1120.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1689.5
            },
            {
              "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": 1326.74
            },
            {
              "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": 1671.16
            },
            {
              "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": 1671.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1131.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1288.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1671.16
            },
            {
              "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": 1131.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1487.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1120.9
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2038,
              "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": 2038,
              "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": 1732.3
            },
            {
              "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": 1689.5
            },
            {
              "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": 1120.9
            },
            {
              "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": 1308.4
            },
            {
              "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": 1308.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1326.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1288.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.6,
              "estimated_amount": 156.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1308.4
            },
            {
              "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": 1308.4
            },
            {
              "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": 1732.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 59.43,
              "estimated_amount": 59.43
            }
          ],
          "minimum": 59.43,
          "maximum": 156.6
        }
      ]
    },
    {
      "description": "HC Vad Insert Extracorp Biventricular",
      "code_information": [
        {
          "code": "PX-36000006",
          "type": "CDM"
        },
        {
          "code": "33976",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10242,
          "discounted_cash": 6657.3,
          "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": 6575.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6657.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10242,
              "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": 6667.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5633.1
            },
            {
              "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": 8398.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8398.44
            },
            {
              "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": 8705.7
            },
            {
              "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": 5633.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 10242
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "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": 2796.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7681.5
            },
            {
              "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": 10242,
              "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": 6575.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8490.62
            },
            {
              "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": 10242,
              "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": 8705.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8398.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "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": 6667.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6667.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6472.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10242,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10242,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6472.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7476.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10242,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5633.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6667.54
            },
            {
              "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": 10242,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7681.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "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": 8982.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6472.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 10242
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7476.66
            },
            {
              "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": 8398.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8398.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8490.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7476.66
            },
            {
              "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": 10242,
              "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": 10242,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8398.44
            },
            {
              "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": 6667.54
            },
            {
              "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": 6472.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8285.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6472.94
            },
            {
              "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": 7476.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10242,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6472.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8490.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5633.1
            },
            {
              "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": 6472.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8398.44
            },
            {
              "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": 8982.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 10242
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5633.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7476.66
            },
            {
              "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": 9012.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7681.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "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": 6575.36
            },
            {
              "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": 8285.78
            },
            {
              "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": 8705.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 10242
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7476.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8705.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8398.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6472.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10242
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5633.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6575.36
            },
            {
              "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": 6575.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5633.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Closed Manipulation in Pacu",
      "code_information": [
        {
          "code": "PX-36000013",
          "type": "CDM"
        },
        {
          "code": "36000013",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 796,
          "discounted_cash": 517.4,
          "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": 511.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 643.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 518.2
            },
            {
              "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": 700.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 659.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 796,
              "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": 676.6
            },
            {
              "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": 503.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 437.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 597
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 518.2
            },
            {
              "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": 503.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 796
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 581.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 581.08
            },
            {
              "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": 676.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 581.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 437.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "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": 518.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 652.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 796
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 796,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 796,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 796
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "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": 659.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 503.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 597
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 503.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 517.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 652.72
            },
            {
              "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": 217.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 503.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 796,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "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": 503.07
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 796,
              "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": 652.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 437.8
            },
            {
              "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": 437.8
            },
            {
              "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": 796,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 581.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 796,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "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": 698.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 503.07
            },
            {
              "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": 643.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 518.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 597
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 698.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 796
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 511.03
            },
            {
              "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": 652.72
            },
            {
              "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": 796,
              "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": 511.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "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": 511.03
            },
            {
              "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": 518.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 581.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 437.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 581.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 676.6
            },
            {
              "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": 652.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 437.8
            },
            {
              "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": 796,
              "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": 652.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 659.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 652.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 796,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 652.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 796
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 437.8
            },
            {
              "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": 511.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 503.07
            }
          ]
        }
      ]
    },
    {
      "description": "HC or Level 2 Addl 15 Minutes",
      "code_information": [
        {
          "code": "PX-36000028",
          "type": "CDM"
        },
        {
          "code": "36000028",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2293,
          "discounted_cash": 1490.45,
          "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": 1472.11
            },
            {
              "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": 1855.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2293,
              "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": 1449.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "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": 1900.9
            },
            {
              "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": 1673.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1855.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1492.74
            },
            {
              "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": 625.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2017.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "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": 2293,
              "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": 2293,
              "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": 1673.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "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": 1472.11
            },
            {
              "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": 1490.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "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": 1472.11
            },
            {
              "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": 1492.74
            },
            {
              "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": 1880.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1900.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "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": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "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": 1492.74
            },
            {
              "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": 2293,
              "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": 1949.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1719.75
            },
            {
              "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": 2010.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2293
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2293
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "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": 1472.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1492.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2293,
              "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": 1949.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2293
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1719.75
            },
            {
              "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": 1949.05
            },
            {
              "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": 2010.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1719.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1492.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2293
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2293
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1900.9
            },
            {
              "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": 1949.05
            },
            {
              "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": 1261.15
            },
            {
              "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": 1472.11
            },
            {
              "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": 1880.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "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": 1880.26
            }
          ]
        }
      ]
    },
    {
      "description": "HC or Level 3 Addl 15 Minutes",
      "code_information": [
        {
          "code": "PX-36000030",
          "type": "CDM"
        },
        {
          "code": "36000030",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3613,
          "discounted_cash": 2348.45,
          "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": 2319.55
            },
            {
              "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": 2352.06
            },
            {
              "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": 2637.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2637.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "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": 2283.42
            },
            {
              "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": 2319.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2922.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2995.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3613,
              "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": 2319.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2283.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3613
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3613,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2709.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1987.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2319.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2319.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3613,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2962.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3613,
              "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": 2962.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3613
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3613,
              "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": 2922.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1987.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2319.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2637.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2709.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2709.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2352.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1987.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2637.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3613,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2352.06
            },
            {
              "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": 2319.55
            },
            {
              "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": 2352.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "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": 2319.55
            },
            {
              "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": 2962.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2283.42
            },
            {
              "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": 3071.05
            },
            {
              "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": 2283.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "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": 2319.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2352.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2962.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2319.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2637.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2283.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3613
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "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": 3168.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3613,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1987.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3613,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3168.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2995.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2283.42
            },
            {
              "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": 2319.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2962.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2348.45
            },
            {
              "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": 2995.18
            },
            {
              "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": 2283.42
            },
            {
              "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": 2962.66
            },
            {
              "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": 3071.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2283.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3613
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1987.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3613,
              "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": 2962.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2962.66
            },
            {
              "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": 3613,
              "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": 1987.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3613
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2637.49
            },
            {
              "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": 3179.44
            },
            {
              "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": 1987.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2319.55
            },
            {
              "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": 986.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3071.05
            }
          ]
        }
      ]
    },
    {
      "description": "HC High Cost Applic Ss Hhfg 1st 25 Up to 100 Sqcm",
      "code_information": [
        {
          "code": "PX-36100047",
          "type": "CDM"
        },
        {
          "code": "15275",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3305,
          "discounted_cash": 2148.25,
          "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": 2121.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2151.56
            },
            {
              "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": 1591.63,
              "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": 1607.55,
              "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": 1671.21,
              "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": 2121.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2121.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3305
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2809.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2809.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2121.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2478.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2710.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 2478.75
            },
            {
              "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": 1607.55,
              "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": 2809.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2809.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1817.75
            },
            {
              "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": 2121.81
            },
            {
              "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": 2151.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2088.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 3305,
              "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": 3305,
              "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": 2809.25
            },
            {
              "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": 2088.76
            },
            {
              "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": 2908.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2412.65
            },
            {
              "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": 2121.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2809.25
            },
            {
              "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": 902.27
            },
            {
              "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": 2710.1
            },
            {
              "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": 1671.21,
              "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": 2809.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 2809.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1817.75
            },
            {
              "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": 2710.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1834.28
            },
            {
              "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": 2088.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 2739.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2121.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1817.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1817.75
            },
            {
              "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": 2148.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2121.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 3305,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3305,
              "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": 1817.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2412.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2809.25
            },
            {
              "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": 3305,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1624.11,
              "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": 2710.1
            },
            {
              "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": 2710.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 3305,
              "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": 2809.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3305,
              "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": 1817.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2739.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2478.75
            },
            {
              "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": 1671.21,
              "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": 2412.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2121.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2809.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2088.76
            },
            {
              "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": 2151.56
            },
            {
              "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": 1591.63,
              "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": 2088.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 2809.25
            },
            {
              "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": 2121.81
            },
            {
              "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": 1591.63,
              "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": 1834.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2673.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 2121.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2151.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2710.1
            },
            {
              "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": 2673.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 2739.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2088.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 2151.56
            },
            {
              "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": 2809.25
            },
            {
              "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": 1607.55,
              "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": 2088.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1817.75
            },
            {
              "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": 1624.11,
              "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": 3305,
              "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": 3305,
              "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": 1607.55,
              "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": 3305,
              "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": 2809.25
            },
            {
              "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": 1591.63,
              "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": 2898.49
            },
            {
              "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": 1607.55,
              "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": 2121.81
            },
            {
              "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": 1834.28
            },
            {
              "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": 1834.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2412.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2412.65
            },
            {
              "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": 2898.49
            },
            {
              "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": 2088.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2710.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3305,
              "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": 3305,
              "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": 2710.1
            },
            {
              "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": 1624.11,
              "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": 2412.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC Rem FB Muscle or Tendon Sheath Simple",
      "code_information": [
        {
          "code": "PX-36100078",
          "type": "CDM"
        },
        {
          "code": "20520",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4115,
          "discounted_cash": 2674.75,
          "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": 2641.83
            },
            {
              "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": 2678.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2600.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2600.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 4115,
              "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": 3411.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2600.68
            },
            {
              "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": 3608.86
            },
            {
              "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": 3374.3
            },
            {
              "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": 2600.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 3374.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3374.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2263.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2263.25
            },
            {
              "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": 4115,
              "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": 2263.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2641.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "additional_payer_notes": "OP SURG "
            },
            {
              "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": 4115,
              "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": 2641.83
            },
            {
              "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": 3374.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2641.83
            },
            {
              "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": 3411.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2263.25
            },
            {
              "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": 3497.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3329.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3374.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3411.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3086.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "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": 3329.04
            },
            {
              "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": 2263.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3003.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3003.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2600.68
            },
            {
              "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": 3621.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 4115,
              "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": 3497.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 4115,
              "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": 2641.83
            },
            {
              "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": 2600.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 2674.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3086.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2263.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 2641.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3374.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2641.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 4115,
              "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": 4115,
              "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": 2600.68
            },
            {
              "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": 3608.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "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": 1123.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4115,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2263.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "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": 2641.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2678.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2678.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3003.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "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": 2641.83
            },
            {
              "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": 2641.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3003.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 4115,
              "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": 4115,
              "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": 3497.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3497.75
            },
            {
              "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": 3374.3
            },
            {
              "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": 2641.83
            },
            {
              "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": 2678.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3374.3
            },
            {
              "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": 4115,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 4115,
              "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": 3003.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2600.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4115,
              "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": 3003.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2641.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2678.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3086.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tendon Origin Insertion",
      "code_information": [
        {
          "code": "PX-36100081",
          "type": "CDM"
        },
        {
          "code": "20551",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5246,
          "discounted_cash": 3409.9,
          "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": 3367.93
            },
            {
              "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": 258.5,
              "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": 3829.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3829.58
            },
            {
              "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": 261.09,
              "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": 258.5,
              "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": 4459.1
            },
            {
              "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": 261.09,
              "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": 5246,
              "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": 5246,
              "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": 4459.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "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": 271.43,
              "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": 261.09,
              "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": 3367.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5246,
              "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": 4301.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3934.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4348.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3415.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4301.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3315.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5246,
              "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": 5246,
              "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": 258.5,
              "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": 3415.15
            },
            {
              "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": 4600.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3315.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5246,
              "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": 3829.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3829.58
            },
            {
              "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": 4459.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3934.5
            },
            {
              "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": 3315.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3367.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3367.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4301.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2885.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3829.58
            },
            {
              "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": 261.09,
              "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": 5246,
              "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": 5246,
              "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": 5246,
              "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": 3367.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5246,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5246,
              "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": 4459.1
            },
            {
              "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": 1148.87
            },
            {
              "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": 2885.3
            },
            {
              "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": 3829.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4301.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3367.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3315.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "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": 258.5,
              "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": 5246,
              "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": 5246,
              "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": 5246,
              "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": 5246,
              "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": 3367.93
            },
            {
              "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": 1432.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2885.3
            },
            {
              "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": 263.78,
              "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": 4348.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2885.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2885.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3367.93
            },
            {
              "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": 3367.93
            },
            {
              "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": 5246,
              "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": 5246,
              "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": 263.78,
              "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": 4459.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3415.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2885.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "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": 261.09,
              "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": 3367.93
            },
            {
              "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": 271.43,
              "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": 3315.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3315.47
            },
            {
              "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": 3315.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5246,
              "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": 4600.74
            },
            {
              "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": 3409.9
            },
            {
              "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": 3367.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3367.93
            },
            {
              "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": 3415.15
            },
            {
              "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": 4244.01
            },
            {
              "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": 4301.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2885.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "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": 4616.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4301.72
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5246,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5246,
              "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": 271.43,
              "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": 4301.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3934.5
            },
            {
              "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": 263.78,
              "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": 4301.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3315.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4459.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3415.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4244.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4348.93
            },
            {
              "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": 5246,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5246,
              "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": 4459.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Biopsy Soft Tissue Back or Flank Deep",
      "code_information": [
        {
          "code": "PX-36100096",
          "type": "CDM"
        },
        {
          "code": "21925",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6865,
          "discounted_cash": 4462.25,
          "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": 4407.33
            },
            {
              "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": 4407.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5629.3
            },
            {
              "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": 6865,
              "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": 6865,
              "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": 5835.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5629.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3775.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5011.45
            },
            {
              "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": 4407.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4407.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5691.09
            },
            {
              "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": 4338.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5011.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4338.68
            },
            {
              "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": 4469.12
            },
            {
              "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": 6865,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5629.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5011.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5835.25
            },
            {
              "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": 3775.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4469.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5629.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5835.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4462.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5835.25
            },
            {
              "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": 5629.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3775.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5148.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4338.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 5835.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4407.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3775.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3775.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4338.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5011.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 5691.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4407.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4469.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 5835.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5835.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4338.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 6865,
              "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": 5835.25
            },
            {
              "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": 6865,
              "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": 5835.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5011.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4338.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 1874.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5835.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5553.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5148.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3775.75
            },
            {
              "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": 6020.61
            },
            {
              "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": 4338.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3775.75
            },
            {
              "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": 6865,
              "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": 4407.33
            },
            {
              "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": 5553.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4407.33
            },
            {
              "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": 5629.3
            },
            {
              "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": 4338.68
            },
            {
              "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": 6865,
              "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": 6865,
              "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": 5691.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 5148.75
            },
            {
              "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": 4407.33
            },
            {
              "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": 4407.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6865,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 6865,
              "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": 5011.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5835.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5629.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 4407.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4469.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 6041.2
            },
            {
              "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": 5629.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6020.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5835.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6865,
              "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": 4407.33
            },
            {
              "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": 4469.12
            }
          ]
        }
      ]
    },
    {
      "description": "HC Inj Arthrography Shoulder",
      "code_information": [
        {
          "code": "PX-36100107",
          "type": "CDM"
        },
        {
          "code": "23350",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1238,
          "discounted_cash": 804.7,
          "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": 794.8
            },
            {
              "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": 1015.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 782.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.8
            },
            {
              "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": 1026.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1001.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1015.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.8
            },
            {
              "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": 794.8
            },
            {
              "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": 805.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 928.5
            },
            {
              "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": 1052.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 805.94
            },
            {
              "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": 1238,
              "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": 805.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 782.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 794.8
            },
            {
              "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": 1001.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1015.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 1052.3
            },
            {
              "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": 1238,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 1238,
              "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": 680.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1026.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1238,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 1238,
              "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": 794.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1015.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "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": 804.7
            },
            {
              "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": 782.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1015.16
            },
            {
              "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": 794.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1015.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 1238,
              "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": 1238,
              "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": 794.8
            },
            {
              "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": 782.42
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.74
            },
            {
              "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": 1238,
              "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": 1238,
              "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": 1089.44
            },
            {
              "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": 1238,
              "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": 1238,
              "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": 1238,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "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": 1085.73
            },
            {
              "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": 1238,
              "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": 680.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 1238,
              "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": 794.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 782.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 1238,
              "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": 1052.3
            },
            {
              "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": 1238,
              "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": 1238,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1015.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 782.42
            },
            {
              "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": 1238,
              "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": 1238,
              "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": 337.97
            },
            {
              "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": 903.74
            },
            {
              "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": 1238,
              "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": 1238,
              "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": 903.74
            },
            {
              "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": 1238,
              "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": 1238,
              "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": 1238,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "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": 782.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1238,
              "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": 794.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.94
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1238,
              "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": 1015.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 928.5
            },
            {
              "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": 1238,
              "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": 680.9
            },
            {
              "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": 1085.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 782.42
            },
            {
              "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": 1238,
              "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": 903.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.74
            },
            {
              "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": 805.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1238,
              "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": 1238,
              "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": 1238,
              "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": 1026.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1052.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 928.5
            },
            {
              "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": 1238,
              "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": 794.8
            }
          ]
        }
      ]
    },
    {
      "description": "HC Repair Hand Tendon or Flexor",
      "code_information": [
        {
          "code": "PX-36100113",
          "type": "CDM"
        },
        {
          "code": "26418",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2801,
          "discounted_cash": 1820.65,
          "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": 1798.24
            },
            {
              "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": 1759.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2100.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "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": 1759.03
            },
            {
              "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": 2801,
              "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": 2380.85
            },
            {
              "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": 2322.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1770.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1798.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2296.82
            },
            {
              "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": 1759.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "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": 2801,
              "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": 2100.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1817.85
            },
            {
              "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": 2801,
              "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": 1798.24
            },
            {
              "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": 2296.82
            },
            {
              "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": 2296.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2801,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1540.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2322.03
            },
            {
              "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": 2801,
              "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": 1770.23
            },
            {
              "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": 1770.23
            },
            {
              "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": 1798.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1823.45
            },
            {
              "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": 2380.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2044.73
            },
            {
              "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": 1798.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2801,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1770.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "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": 2456.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "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": 1823.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1817.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1540.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1817.85
            },
            {
              "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": 1820.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1540.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2044.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1798.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2296.82
            },
            {
              "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": 2456.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1823.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1540.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1823.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1798.24
            },
            {
              "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": 2266.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "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": 1770.23
            },
            {
              "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": 1770.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1540.55
            },
            {
              "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": 1540.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2266.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "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": 1798.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1798.24
            },
            {
              "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": 1798.24
            },
            {
              "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": 2296.82
            },
            {
              "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": 2464.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1770.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1759.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1540.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2380.85
            },
            {
              "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": 764.67
            },
            {
              "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": 1823.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2322.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2801,
              "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": 1770.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2044.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2801,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2801,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1798.24
            },
            {
              "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": 2044.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2296.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2100.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2044.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2296.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2296.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2801,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2044.73
            },
            {
              "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": 2380.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1798.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1817.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC Bronchoscopy W Needle Bx Ea Addl Lobe",
      "code_information": [
        {
          "code": "PX-36100141",
          "type": "CDM"
        },
        {
          "code": "31633",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4680,
          "discounted_cash": 3042,
          "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": 3004.56
            },
            {
              "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": 3046.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2957.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2957.76
            },
            {
              "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": 4104.36
            },
            {
              "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": 4680,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3416.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2957.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 4680,
              "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": 3978
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3416.4
            },
            {
              "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": 3837.6
            },
            {
              "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": 4680,
              "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": 3978
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4680,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3837.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 3416.4
            },
            {
              "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": 4680,
              "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": 4680,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3004.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2957.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 4680,
              "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": 4680,
              "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": 4680,
              "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": 3004.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 4680,
              "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": 3416.4
            },
            {
              "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": 4680,
              "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": 4680,
              "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": 3837.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3510
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3837.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3510
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4680,
              "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": 3510
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3837.6
            },
            {
              "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": 4680,
              "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": 3004.56
            },
            {
              "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": 3004.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3046.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3837.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3879.72
            },
            {
              "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": 4680,
              "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": 4680,
              "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": 4680,
              "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": 4680,
              "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": 3978
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3004.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3004.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3004.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 2574
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3879.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3046.68
            },
            {
              "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": 1277.64
            },
            {
              "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": 4680,
              "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": 4680,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 692
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3004.56
            },
            {
              "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": 4680,
              "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": 3004.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3004.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3837.6
            },
            {
              "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": 4680,
              "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": 3978
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4680,
              "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": 4680,
              "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": 4118.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2957.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2957.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 3416.4
            },
            {
              "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": 4104.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2957.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3786.12
            },
            {
              "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": 2957.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 3042
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3046.68
            },
            {
              "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": 4680,
              "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": 3978
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3879.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 4680,
              "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": 4680,
              "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": 3416.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 3978
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3004.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4680,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4680,
              "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": 2574
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3046.68
            },
            {
              "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": 3786.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3837.6
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Pulse Generator Only Dual",
      "code_information": [
        {
          "code": "PX-36100176",
          "type": "CDM"
        },
        {
          "code": "33213",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18580,
          "discounted_cash": 12077,
          "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": 11928.36
            },
            {
              "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": 12095.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10219
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 13935
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12095.58
            },
            {
              "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": 13563.4
            },
            {
              "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": 9413.03,
              "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": 9413.03,
              "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": 9785.82,
              "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": 3344.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10219
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10219
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11928.36
            },
            {
              "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": 4069.02
            },
            {
              "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": 9122.84,
              "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": 9413.03,
              "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": 15235.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 9413.03,
              "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": 15402.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 16350.4
            },
            {
              "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": 15235.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 9785.82,
              "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": 16294.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10219
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11928.36
            },
            {
              "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": 9122.84,
              "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": 9578.98,
              "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": 15235.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9413.03,
              "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": 11742.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 12077
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9309.02,
              "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": 15235.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 13935
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 13563.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15235.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10219
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 18580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11742.56
            },
            {
              "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": 15402.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 15031.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15031.22
            },
            {
              "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": 18580,
              "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": 18580,
              "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": 18580,
              "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": 18580,
              "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": 15402.82
            },
            {
              "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": 3344.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11928.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 9309.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11928.36
            },
            {
              "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": 12095.58
            },
            {
              "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": 9122.84,
              "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": 15793
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 18580
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 15235.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 18580
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13563.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11928.36
            },
            {
              "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": 9122.84,
              "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": 15793
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18580,
              "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": 10219
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 11928.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11742.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12095.58
            },
            {
              "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": 5072.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13563.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11742.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 15793
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11928.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12095.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 18580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11742.56
            },
            {
              "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": 11928.36
            },
            {
              "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": 15235.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11742.56
            },
            {
              "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": 11742.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 15793
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 18580
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11928.36
            },
            {
              "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": 11928.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11742.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18580,
              "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": 11928.36
            },
            {
              "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": 15793
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10219
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18580,
              "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": 15235.6
            },
            {
              "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": 9309.02,
              "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": 16294.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13563.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13935
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13563.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15793
            }
          ]
        }
      ]
    },
    {
      "description": "HC Upgrade Implanted Pacemaker",
      "code_information": [
        {
          "code": "PX-36100177",
          "type": "CDM"
        },
        {
          "code": "33214",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 31030,
          "discounted_cash": 20169.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "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": 25103.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 26375.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 31030
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 23272.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22651.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25444.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19610.96
            },
            {
              "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": 9510.03,
              "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": 23272.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17066.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17066.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26375.5
            },
            {
              "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": 9785.82,
              "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": 31030,
              "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": 31030,
              "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": 26375.5
            },
            {
              "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": 20200.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20200.53
            },
            {
              "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": 5585.4
            },
            {
              "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": 19921.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "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": 6795.57
            },
            {
              "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": 25723.87
            },
            {
              "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": 19610.96
            },
            {
              "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": 19610.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 26375.5
            },
            {
              "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": 25444.6
            },
            {
              "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": 25444.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25444.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 25723.87
            },
            {
              "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": 31030,
              "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": 19921.26
            },
            {
              "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": 9319.83,
              "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": 9413.03,
              "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": 19610.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 22651.9
            },
            {
              "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": 9785.82,
              "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": 25444.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17066.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 31030,
              "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": 9413.03,
              "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": 9319.83,
              "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": 26375.5
            },
            {
              "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": 31030,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 31030
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "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": 19921.26
            },
            {
              "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": 9319.83,
              "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": 25723.87
            },
            {
              "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": 9510.03,
              "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": 27306.4
            },
            {
              "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": 9413.03,
              "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": 20169.5
            },
            {
              "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": 9413.03,
              "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": 9319.83,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 31030
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20200.53
            },
            {
              "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": 26375.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 31030,
              "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": 19921.26
            },
            {
              "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": 8471.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22651.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26375.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 31030
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 5585.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 31030
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26375.5
            },
            {
              "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": 31030,
              "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": 26375.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26375.5
            },
            {
              "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": 27213.31
            },
            {
              "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": 27213.31
            },
            {
              "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": 9510.03,
              "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": 19610.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22651.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22651.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 25103.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25444.6
            },
            {
              "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": 17066.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17066.5
            },
            {
              "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": 22651.9
            },
            {
              "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": 25444.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26375.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20200.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 19610.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19610.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31030,
              "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": 26375.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26375.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25444.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26375.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23272.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19921.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17066.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17066.5
            },
            {
              "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": 9413.03,
              "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": 31030,
              "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": 31030,
              "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": 20200.53
            },
            {
              "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": 31030,
              "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": 19610.96
            },
            {
              "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": 9785.82,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Revision Skin Pocket Pacemaker",
      "code_information": [
        {
          "code": "PX-36100184",
          "type": "CDM"
        },
        {
          "code": "33222",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 19342,
          "discounted_cash": 12572.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12417.56
            },
            {
              "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": 1607.55,
              "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": 16440.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12224.14
            },
            {
              "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": 16962.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 1624.11,
              "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": 16440.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "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": 12417.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15860.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14506.5
            },
            {
              "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": 1607.55,
              "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": 12417.56
            },
            {
              "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": 12417.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1671.21,
              "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": 16034.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 3481.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10638.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10638.1
            },
            {
              "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": 16962.93
            },
            {
              "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": 12591.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 19342,
              "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": 14119.66
            },
            {
              "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": 12591.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 16440.7
            },
            {
              "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": 14119.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "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": 3481.56
            },
            {
              "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": 15860.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 4235.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "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": 12417.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "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": 1591.63,
              "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": 12224.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1624.11,
              "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": 15860.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15860.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 1607.55,
              "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": 16440.7
            },
            {
              "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": 19342,
              "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": 16440.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14506.5
            },
            {
              "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": 19342,
              "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": 12591.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1624.11,
              "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": 16034.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12224.14
            },
            {
              "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": 1591.63,
              "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": 1671.21,
              "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": 10638.1
            },
            {
              "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": 10638.1
            },
            {
              "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": 1607.55,
              "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": 10638.1
            },
            {
              "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": 1591.63,
              "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": 12417.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12417.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12417.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10638.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15860.44
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1591.63,
              "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": 12572.3
            },
            {
              "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": 5280.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14119.66
            },
            {
              "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": 16034.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14506.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 19342,
              "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": 19342,
              "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": 16440.7
            },
            {
              "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": 12224.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 15647.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12224.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 10638.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 19342,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12224.14
            },
            {
              "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": 19342,
              "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": 17020.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12417.56
            },
            {
              "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": 12417.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12591.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "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": 12224.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 14119.66
            },
            {
              "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": 19342,
              "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": 12417.56
            },
            {
              "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": 15647.68
            },
            {
              "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": 15860.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16440.7
            },
            {
              "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": 15860.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14119.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12591.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19342,
              "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": 14119.66
            },
            {
              "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": 1607.55,
              "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": 12417.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15860.44
            },
            {
              "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": 1671.21,
              "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": 12224.14
            }
          ]
        }
      ]
    },
    {
      "description": "HC Rem and Replace Pacer Pulse Gen Dual",
      "code_information": [
        {
          "code": "PX-36100190",
          "type": "CDM"
        },
        {
          "code": "33228",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22315,
          "discounted_cash": 14504.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14527.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16289.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9785.82,
              "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": 22315,
              "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": 18967.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 22315,
              "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": 9510.03,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 22315
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22315,
              "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": 14527.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 22315
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 12273.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 22315,
              "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": 18298.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "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": 19637.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 9319.83,
              "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": 16289.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16736.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12273.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "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": 9319.83,
              "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": 18499.14
            },
            {
              "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": 14103.08
            },
            {
              "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": 9785.82,
              "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": 16736.25
            },
            {
              "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": 9413.03,
              "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": 22315,
              "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": 14326.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 22315,
              "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": 18052.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18298.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18499.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12273.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "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": 14326.23
            },
            {
              "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": 9413.03,
              "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": 18967.75
            },
            {
              "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": 4886.99
            },
            {
              "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": 9510.03,
              "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": 22315,
              "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": 22315,
              "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": 18967.75
            },
            {
              "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": 22315,
              "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": 12273.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16289.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "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": 14326.23
            },
            {
              "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": 18298.3
            },
            {
              "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": 9319.83,
              "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": 18967.75
            },
            {
              "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": 9785.82,
              "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": 9319.83,
              "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": 14103.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18298.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16289.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 22315,
              "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": 9413.03,
              "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": 14527.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 4016.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "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": 14326.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18298.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18499.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14103.08
            },
            {
              "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": 14103.08
            },
            {
              "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": 14103.08
            },
            {
              "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": 4016.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14326.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 22315
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16289.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 22315
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12273.25
            },
            {
              "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": 9413.03,
              "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": 19570.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16736.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18052.84
            },
            {
              "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": 19570.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14527.07
            },
            {
              "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": 12273.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 9510.03,
              "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": 18967.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18298.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 12273.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14103.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14103.08
            },
            {
              "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": 9413.03,
              "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": 18967.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 22315
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18967.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18298.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14103.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22315,
              "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": 6092
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 14504.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16289.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14527.07
            },
            {
              "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": 18298.3
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Icd Generator Only Mult",
      "code_information": [
        {
          "code": "PX-36100193",
          "type": "CDM"
        },
        {
          "code": "33231",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18445,
          "discounted_cash": 11989.25,
          "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": 11841.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12007.7
            },
            {
              "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": 15124.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11841.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15124.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15678.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11841.69
            },
            {
              "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": 11657.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 11841.69
            },
            {
              "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": 15124.9
            },
            {
              "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": 5035.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 15678.25
            },
            {
              "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": 11657.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15678.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10144.75
            },
            {
              "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": 15678.25
            },
            {
              "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": 15290.91
            },
            {
              "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": 11841.69
            },
            {
              "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": 12007.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 15678.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11841.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11657.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13464.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13464.85
            },
            {
              "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": 11841.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15290.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18445,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18445,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11657.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12007.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15124.9
            },
            {
              "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": 11841.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 18445,
              "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": 18445,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13464.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15678.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11657.24
            },
            {
              "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": 11657.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10144.75
            },
            {
              "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": 18445,
              "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": 18445,
              "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": 18445,
              "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": 15678.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10144.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10144.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14922.01
            },
            {
              "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": 18445,
              "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": 13833.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15290.91
            },
            {
              "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": 12007.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15678.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 11989.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10144.75
            },
            {
              "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": 16176.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 18445,
              "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": 18445,
              "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": 13833.75
            },
            {
              "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": 18445,
              "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": 16231.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13464.85
            },
            {
              "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": 18445,
              "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": 13833.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12007.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 18445,
              "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": 15678.25
            },
            {
              "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": 13464.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 11841.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 11841.69
            },
            {
              "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": 15124.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15678.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15678.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "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": 15124.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15124.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18445,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11657.24
            },
            {
              "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": 10144.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10144.75
            },
            {
              "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": 11841.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15124.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11657.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13464.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11841.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15678.25
            },
            {
              "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": 16176.27
            },
            {
              "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": 14922.01
            }
          ]
        }
      ]
    },
    {
      "description": "HC Inj Sclerosing Soln Mult Incompetent Veins Same Leg",
      "code_information": [
        {
          "code": "PX-36100282",
          "type": "CDM"
        },
        {
          "code": "36471",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 648,
          "discounted_cash": 421.2,
          "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": 416.02
            },
            {
              "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": 351.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 486
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 648
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "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": 351.5,
              "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": 63.2,
              "estimated_amount": 409.54
            },
            {
              "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": 568.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "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": 416.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 570.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 421.85
            },
            {
              "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": 176.9
            },
            {
              "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": 550.8
            },
            {
              "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": 648,
              "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": 568.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 365.42,
              "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": 648,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 486
            },
            {
              "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": 648,
              "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": 648,
              "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": 531.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 486
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "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": 356.4
            },
            {
              "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": 648,
              "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": 648,
              "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": 409.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 348.02,
              "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": 356.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 648
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 351.5,
              "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": 648,
              "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": 648,
              "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": 365.42,
              "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": 348.02,
              "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": 348.02,
              "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": 648,
              "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": 648,
              "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": 550.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 550.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "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": 537.19
            },
            {
              "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": 421.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 648
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "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": 416.02
            },
            {
              "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": 416.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 537.19
            },
            {
              "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": 416.02
            },
            {
              "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": 351.5,
              "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": 648,
              "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": 648,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "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": 421.85
            },
            {
              "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": 409.54
            },
            {
              "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": 409.54
            },
            {
              "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": 355.12,
              "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": 550.8
            },
            {
              "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": 348.02,
              "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": 648,
              "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": 550.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 648
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 537.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "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": 409.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 473.04
            },
            {
              "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": 421.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 356.4
            },
            {
              "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": 524.23
            },
            {
              "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": 351.5,
              "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": 416.02
            },
            {
              "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": 416.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 421.85
            },
            {
              "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": 531.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 648
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 421.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "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": 531.36
            },
            {
              "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": 355.12,
              "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": 550.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 355.12,
              "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": 473.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 524.23
            },
            {
              "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": 531.36
            },
            {
              "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": 365.42,
              "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": 648,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Cva 2 Caths WO Port",
      "code_information": [
        {
          "code": "PX-36100297",
          "type": "CDM"
        },
        {
          "code": "36565",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12240,
          "discounted_cash": 7956,
          "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": 7858.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7858.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7735.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12240,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12240,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7735.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7858.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6732
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7968.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9902.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9180
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 12240,
              "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": 6732
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7956
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10036.8
            },
            {
              "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": 10036.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8935.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9180
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10146.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10146.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10146.96
            },
            {
              "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": 8935.2
            },
            {
              "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": 7858.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 12240,
              "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": 10036.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8935.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8935.2
            },
            {
              "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": 10404
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7858.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10404
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6732
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10404
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7858.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 10771.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 10404
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10404
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10404
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10404
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12240,
              "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": 10404
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6732
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7735.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7735.68
            },
            {
              "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": 7968.24
            },
            {
              "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": 3341.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9180
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6732
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8935.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10036.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 10404
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7858.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10036.8
            },
            {
              "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": 12240,
              "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": 7735.68
            },
            {
              "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": 12240,
              "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": 12240,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 12240,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8935.2
            },
            {
              "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": 7858.08
            },
            {
              "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": 9902.16
            },
            {
              "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": 10734.48
            },
            {
              "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": 7858.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 12240,
              "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": 7968.24
            },
            {
              "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": 10036.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10036.8
            },
            {
              "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": 7735.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 12240,
              "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": 7858.08
            },
            {
              "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": 12240,
              "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": 7968.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 10404
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10734.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10404
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6732
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10036.8
            },
            {
              "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": 7735.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12240,
              "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": 12240,
              "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": 7858.08
            },
            {
              "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": 7968.24
            },
            {
              "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": 6732
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7858.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7735.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10404
            }
          ]
        }
      ]
    },
    {
      "description": "HC Trnscth Tx Thrmb Subq Day",
      "code_information": [
        {
          "code": "PX-36100348",
          "type": "CDM"
        },
        {
          "code": "37213",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39480,
          "discounted_cash": 25662,
          "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": 25346.16
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39480,
              "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": 39480,
              "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": 25346.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28820.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 39480,
              "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": 32373.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32373.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32373.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 24951.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21714
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 25662
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34623.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 39480,
              "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": 33558
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21714
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24951.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25346.16
            },
            {
              "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": 25346.16
            },
            {
              "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": 24951.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 25346.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25346.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39480,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29610
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32373.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32728.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 32728.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21714
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28820.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25701.48
            },
            {
              "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": 31939.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31939.32
            },
            {
              "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": 25701.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 33558
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28820.4
            },
            {
              "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": 39480,
              "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": 39480,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32373.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32728.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24951.36
            },
            {
              "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": 39480,
              "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": 25346.16
            },
            {
              "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": 25346.16
            },
            {
              "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": 32373.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25346.16
            },
            {
              "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": 10778.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 39480,
              "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": 33558
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 39480,
              "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": 21714
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28820.4
            },
            {
              "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": 24951.36
            },
            {
              "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": 25346.16
            },
            {
              "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": 25346.16
            },
            {
              "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": 32373.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29610
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 39480,
              "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": 29610
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24951.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25346.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33558
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24951.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25701.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32373.6
            },
            {
              "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": 28820.4
            },
            {
              "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": 33558
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34623.96
            },
            {
              "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": 34742.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25701.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25701.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21714
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28820.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39480,
              "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": 21714
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21714
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24951.36
            }
          ]
        }
      ]
    },
    {
      "description": "HC Revasc/Endo Iliac W Stnt W/WO Pta",
      "code_information": [
        {
          "code": "PX-36100353",
          "type": "CDM"
        },
        {
          "code": "37221",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21474,
          "discounted_cash": 13958.1,
          "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": 13786.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18252.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15676.02
            },
            {
              "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": 9697.66,
              "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": 18252.9
            },
            {
              "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": 17608.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15676.02
            },
            {
              "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": 11810.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13979.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 9697.66,
              "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": 21474,
              "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": 21474,
              "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": 21474,
              "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": 18252.9
            },
            {
              "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": 21474,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 21474
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 21474
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13786.31
            },
            {
              "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": 18897.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11810.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13571.57
            },
            {
              "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": 9601.65,
              "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": 18252.9
            },
            {
              "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": 9697.66,
              "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": 9601.65,
              "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": 13979.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13786.31
            },
            {
              "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": 13786.31
            },
            {
              "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": 18832.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18252.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 18252.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17801.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15676.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16105.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13571.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13571.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 13786.31
            },
            {
              "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": 17801.95
            },
            {
              "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": 21474,
              "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": 13786.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18252.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11810.7
            },
            {
              "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": 9601.65,
              "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": 18252.9
            },
            {
              "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": 18832.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 11810.7
            },
            {
              "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": 17608.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 11810.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15676.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18252.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15676.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13979.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13979.57
            },
            {
              "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": 5862.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 21474,
              "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": 13786.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17608.68
            },
            {
              "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": 10081.73,
              "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": 17608.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13571.57
            },
            {
              "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": 13958.1
            },
            {
              "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": 17372.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17608.68
            },
            {
              "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": 3865.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3865.32
            },
            {
              "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": 13571.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13786.31
            },
            {
              "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": 13979.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17801.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11810.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18252.9
            },
            {
              "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": 13786.31
            },
            {
              "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": 13571.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16105.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 9797.6,
              "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": 17608.68
            },
            {
              "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": 9601.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 21474
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18252.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 4702.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 21474
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11810.7
            },
            {
              "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": 9697.66,
              "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": 18252.9
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21474,
              "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": 13786.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 21474
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18252.9
            },
            {
              "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": 13786.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17372.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17608.68
            },
            {
              "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": 13786.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 21474,
              "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": 15676.02
            },
            {
              "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": 9697.66,
              "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": 13571.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 9797.6,
              "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": 10081.73,
              "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": 16105.5
            },
            {
              "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": 10081.73,
              "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": 13571.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17608.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21474,
              "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": 9797.6,
              "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": 21474,
              "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": 18252.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC Biliary Endo Perc With Biopsy",
      "code_information": [
        {
          "code": "PX-36100404",
          "type": "CDM"
        },
        {
          "code": "47553",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4207,
          "discounted_cash": 2734.55,
          "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": 2700.89
            },
            {
              "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": 3071.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2658.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3487.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2738.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3449.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3071.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3071.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2700.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2738.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3449.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "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": 3702.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "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": 2700.89
            },
            {
              "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": 3449.74
            },
            {
              "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": 2658.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2658.82
            },
            {
              "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": 2313.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2313.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2313.85
            },
            {
              "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": 2658.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 3575.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3403.46
            },
            {
              "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": 4207,
              "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": 2658.82
            },
            {
              "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": 3449.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3071.11
            },
            {
              "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": 2700.89
            },
            {
              "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": 3689.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 3575.95
            },
            {
              "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": 2738.76
            },
            {
              "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": 3689.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 2734.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 4207,
              "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": 4207,
              "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": 4207,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2700.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2658.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 2700.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3449.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "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": 4207,
              "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": 4207,
              "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": 2700.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2313.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 4207,
              "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": 3575.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2313.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2313.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "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": 2700.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3155.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3071.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2658.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3449.74
            },
            {
              "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": 1148.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 4207,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3155.25
            },
            {
              "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": 3575.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3155.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4207,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3575.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 4207,
              "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": 3071.11
            },
            {
              "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": 2700.89
            },
            {
              "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": 2738.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2700.89
            },
            {
              "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": 3487.6
            },
            {
              "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": 2658.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 3449.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3487.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2738.76
            },
            {
              "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": 3403.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3449.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 4207,
              "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": 4207,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4207,
              "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": 2313.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2700.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2700.89
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection Anes Brachial Plexus",
      "code_information": [
        {
          "code": "PX-36100545",
          "type": "CDM"
        },
        {
          "code": "64415",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5004,
          "discounted_cash": 3252.6,
          "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": 3212.57
            },
            {
              "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": 4048.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4103.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2752.2
            },
            {
              "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": 3252.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5004,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4388.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3652.92
            },
            {
              "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": 3212.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3162.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 5004,
              "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": 5004,
              "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": 4253.4
            },
            {
              "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": 4103.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 3652.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3162.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3212.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3257.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 5004,
              "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": 3753
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3212.57
            },
            {
              "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": 3212.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 4253.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3652.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "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": 3212.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3257.6
            },
            {
              "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": 5004,
              "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": 2752.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 5004,
              "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": 4103.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2752.2
            },
            {
              "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": 4403.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2752.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3212.57
            },
            {
              "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": 4103.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4148.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2752.2
            },
            {
              "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": 3652.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4048.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3162.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "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": 5004,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3753
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1366.09
            },
            {
              "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": 2752.2
            },
            {
              "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": 4253.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3652.92
            },
            {
              "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": 4103.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 5004,
              "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": 5004,
              "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": 3212.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3212.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3257.6
            },
            {
              "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": 3162.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3162.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2752.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3162.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 3212.57
            },
            {
              "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": 3257.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4253.4
            },
            {
              "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": 3212.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4103.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4148.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4148.32
            },
            {
              "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": 3162.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3652.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 3257.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4103.28
            },
            {
              "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": 4388.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 3162.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5004,
              "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": 3212.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4103.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3753
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5004,
              "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": 5004,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Translum Peripheral Atherectomy Brachiocephalic",
      "code_information": [
        {
          "code": "PX-36100613",
          "type": "CDM"
        },
        {
          "code": "0237T",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23984,
          "discounted_cash": 15589.6,
          "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": 15397.73
            },
            {
              "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": 15397.73
            },
            {
              "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": 19666.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17988
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20386.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17508.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 20386.4
            },
            {
              "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": 15157.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15157.89
            },
            {
              "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": 21105.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17988
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15157.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20386.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15613.58
            },
            {
              "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": 15157.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20386.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20386.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17508.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 23984,
              "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": 15157.89
            },
            {
              "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": 21033.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13191.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13191.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19403.06
            },
            {
              "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": 15157.89
            },
            {
              "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": 23984,
              "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": 15613.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20386.4
            },
            {
              "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": 20386.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19666.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19882.74
            },
            {
              "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": 23984,
              "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": 23984,
              "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": 15397.73
            },
            {
              "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": 19403.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 15397.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20386.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13191.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15397.73
            },
            {
              "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": 15613.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19882.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17988
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13191.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 20386.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19666.88
            },
            {
              "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": 6547.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17508.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15157.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15157.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 13191.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13191.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 15589.6
            },
            {
              "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": 15613.58
            },
            {
              "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": 21033.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 23984,
              "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": 19666.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 19882.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 23984,
              "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": 23984,
              "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": 15397.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15397.73
            },
            {
              "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": 19666.88
            },
            {
              "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": 20386.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 23984,
              "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": 17508.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 15397.73
            },
            {
              "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": 15397.73
            },
            {
              "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": 19666.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19666.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23984,
              "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": 23984,
              "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": 23984,
              "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": 15397.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19666.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20386.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13191.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17508.32
            },
            {
              "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": 15397.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15613.58
            },
            {
              "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": 17508.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15397.73
            },
            {
              "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": 23984,
              "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": 20386.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC Exc Bng Lsn Mrgs 1.1-2.0 Cm",
      "code_information": [
        {
          "code": "PX-36100627",
          "type": "CDM"
        },
        {
          "code": "11402",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2140,
          "discounted_cash": 1391,
          "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": 1373.88
            },
            {
              "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": 1373.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1177
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 644.77,
              "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": 1352.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2140
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1819
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1774.06
            },
            {
              "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": 1393.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1562.2
            },
            {
              "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": 620.21,
              "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": 1177
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1731.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "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": 1819
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1605
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 620.21,
              "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": 1819
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "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": 1754.8
            },
            {
              "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": 1754.8
            },
            {
              "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": 1352.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1373.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1393.14
            },
            {
              "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": 644.77,
              "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": 1177
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2140
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1562.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1819
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1731.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1754.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1373.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1819
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1352.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2140
            },
            {
              "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": 2140,
              "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": 1605
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1605
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1177
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1352.48
            },
            {
              "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": 1876.78
            },
            {
              "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": 1373.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1393.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1754.8
            },
            {
              "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": 1754.8
            },
            {
              "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": 614.07,
              "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": 2140,
              "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": 2140,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2140
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1562.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "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": 2140,
              "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": 2140,
              "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": 2140,
              "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": 1754.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1819
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2140,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "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": 1562.2
            },
            {
              "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": 1562.2
            },
            {
              "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": 1373.88
            },
            {
              "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": 1352.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 423
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1373.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1373.88
            },
            {
              "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": 614.07,
              "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": 1562.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "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": 644.77,
              "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": 626.6,
              "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": 1819
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2140,
              "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": 1819
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1352.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1819
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1373.88
            },
            {
              "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": 614.07,
              "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": 1819
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1352.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "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": 2140,
              "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": 2140,
              "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": 1393.14
            },
            {
              "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": 1754.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2140,
              "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": 1391
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1177
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1819
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 620.21,
              "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": 1774.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2140,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1352.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 626.6,
              "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": 1819
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1373.88
            },
            {
              "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": 1373.88
            },
            {
              "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": 584.22
            },
            {
              "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": 626.6,
              "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": 620.21,
              "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": 2140,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2140
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 620.21,
              "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": 1819
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1883.2
            },
            {
              "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": 1393.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1177
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1177
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 614.07,
              "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": 2140,
              "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": 1373.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1754.8
            },
            {
              "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": 1876.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1774.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1819
            }
          ]
        }
      ]
    },
    {
      "description": "HC Red Cells Washed 1 Unit",
      "code_information": [
        {
          "code": "PX-39000013",
          "type": "CDM"
        },
        {
          "code": "P9022",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2074,
          "discounted_cash": 1348.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1331.51
            },
            {
              "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": 1331.51
            },
            {
              "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": 385.21,
              "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": 1762.9
            },
            {
              "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": 1825.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1331.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1350.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1514.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1762.9
            },
            {
              "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": 1514.02
            },
            {
              "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": 385.21,
              "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": 1762.9
            },
            {
              "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": 1151.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1310.77
            },
            {
              "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": 1331.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1350.17
            },
            {
              "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": 1140.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1331.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1331.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1700.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 2074,
              "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": 1719.35
            },
            {
              "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": 1818.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 1762.9
            },
            {
              "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": 385.21,
              "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": 1310.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 1348.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 2074,
              "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": 1151.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1555.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1140.7
            },
            {
              "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": 1700.68
            },
            {
              "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": 2074,
              "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": 1331.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1700.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1140.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 2074,
              "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": 1555.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 1140.7
            },
            {
              "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": 381.39,
              "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": 1700.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1762.9
            },
            {
              "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": 400.46,
              "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": 1310.77
            },
            {
              "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": 400.46,
              "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": 1677.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1700.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1762.9
            },
            {
              "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": 1331.51
            },
            {
              "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": 1350.17
            },
            {
              "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": 381.39,
              "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": 1762.9
            },
            {
              "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": 1310.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1762.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1140.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1140.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1140.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1514.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1514.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 389.18,
              "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": 1762.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1310.77
            },
            {
              "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": 1818.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 385.21,
              "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": 2074,
              "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": 2074,
              "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": 2074,
              "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": 1151.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2074
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1762.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1514.02
            },
            {
              "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": 1151.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1331.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1331.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 1677.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 1762.9
            },
            {
              "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": 385.21,
              "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": 381.39,
              "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": 454.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1350.17
            },
            {
              "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": 566.2
            },
            {
              "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": 400.46,
              "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": 2074,
              "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": 389.18,
              "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": 1700.68
            },
            {
              "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": 1719.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1762.9
            },
            {
              "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": 1350.17
            },
            {
              "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": 1700.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1555.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1310.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 1514.02
            },
            {
              "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": 1310.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 389.18,
              "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": 381.39,
              "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": 1719.35
            },
            {
              "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": 1331.51
            },
            {
              "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": 1310.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1700.68
            },
            {
              "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": 2074,
              "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": 1762.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2074,
              "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": 1331.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1762.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC US Abdomen Complete",
      "code_information": [
        {
          "code": "PX-40200005",
          "type": "CDM"
        },
        {
          "code": "76700",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 611,
          "discounted_cash": 397.15,
          "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": 392.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.02
            },
            {
              "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": 95.95,
              "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": 446.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 97.91,
              "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": 519.35
            },
            {
              "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": 392.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 458.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 392.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 392.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 519.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 519.35
            },
            {
              "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": 392.26
            },
            {
              "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": 535.85
            },
            {
              "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": 96.91,
              "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": 519.35
            },
            {
              "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": 501.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 519.35
            },
            {
              "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": 392.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 519.35
            },
            {
              "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": 386.15
            },
            {
              "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": 446.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 397.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 519.35
            },
            {
              "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": 397.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 96.91,
              "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": 392.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.02
            },
            {
              "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": 339.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 506.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 506.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 519.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.02
            },
            {
              "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": 100.75,
              "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": 386.15
            },
            {
              "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": 386.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 519.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 386.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 397.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 397.76
            },
            {
              "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": 506.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 519.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.03
            },
            {
              "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": 519.35
            },
            {
              "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": 535.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 386.15
            },
            {
              "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": 611,
              "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": 64.2,
              "estimated_amount": 392.26
            },
            {
              "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": 501.02
            },
            {
              "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": 537.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.03
            },
            {
              "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": 611,
              "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": 611,
              "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": 96.91,
              "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": 339.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 611,
              "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": 96.91,
              "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": 95.95,
              "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": 611,
              "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": 97.91,
              "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": 397.76
            },
            {
              "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": 95.95,
              "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": 336.05
            },
            {
              "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": 100.75,
              "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": 166.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 458.25
            },
            {
              "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": 97.91,
              "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": 611,
              "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": 339.11
            },
            {
              "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": 611,
              "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": 519.35
            },
            {
              "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": 392.26
            },
            {
              "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": 397.76
            },
            {
              "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": 494.3
            },
            {
              "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": 386.15
            },
            {
              "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": 611,
              "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": 336.05
            },
            {
              "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": 611,
              "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": 611,
              "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": 494.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 392.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 611,
              "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": 386.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 100.75,
              "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": 392.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 386.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.05
            },
            {
              "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": 392.26
            },
            {
              "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": 336.05
            },
            {
              "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": 96.91,
              "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": 95.95,
              "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": 611,
              "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": 519.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 458.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 611,
              "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": 611
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.02
            },
            {
              "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": 611,
              "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": 611,
              "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": 611,
              "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": 519.35
            },
            {
              "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": 339.11
            },
            {
              "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": 501.02
            }
          ]
        }
      ]
    },
    {
      "description": "HC US Retroperitioneal Limited",
      "code_information": [
        {
          "code": "PX-40200008",
          "type": "CDM"
        },
        {
          "code": "76775",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 487,
          "discounted_cash": 316.55,
          "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": 312.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 317.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 267.85
            },
            {
              "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": 96.91,
              "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": 365.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 317.04
            },
            {
              "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": 317.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 413.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 355.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 487,
              "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": 307.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 487,
              "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": 355.51
            },
            {
              "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": 96.91,
              "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": 399.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 399.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 413.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 399.34
            },
            {
              "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": 132.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 307.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 413.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 399.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 413.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 487
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.91,
              "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": 307.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 487,
              "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": 95.95,
              "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": 487,
              "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": 97.91,
              "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": 267.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 413.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 267.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 365.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 403.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 403.72
            },
            {
              "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": 413.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 312.65
            },
            {
              "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": 95.95,
              "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": 100.75,
              "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": 267.85
            },
            {
              "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": 96.91,
              "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": 100.75,
              "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": 487,
              "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": 312.65
            },
            {
              "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": 317.04
            },
            {
              "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": 399.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 96.91,
              "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": 267.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 312.65
            },
            {
              "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": 270.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 267.85
            },
            {
              "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": 307.78
            },
            {
              "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": 427.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 355.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 100.75,
              "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": 307.78
            },
            {
              "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": 487,
              "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": 413.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 267.85
            },
            {
              "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": 355.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 413.95
            },
            {
              "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": 95.95,
              "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": 312.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 312.65
            },
            {
              "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": 97.91,
              "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": 487,
              "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": 487,
              "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": 413.95
            },
            {
              "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": 487,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 312.65
            },
            {
              "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": 270.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 413.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 487,
              "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": 312.65
            },
            {
              "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": 393.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 317.04
            },
            {
              "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": 399.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 487,
              "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": 413.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 307.78
            },
            {
              "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": 312.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 399.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 365.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 413.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 307.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 413.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 355.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 413.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 270.29
            },
            {
              "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": 95.95,
              "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": 312.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 312.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 393.98
            },
            {
              "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": 399.34
            },
            {
              "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": 427.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 487,
              "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": 428.56
            },
            {
              "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": 487,
              "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": 316.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 307.78
            },
            {
              "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": 97.91,
              "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": 487,
              "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": 270.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 355.51
            },
            {
              "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": 312.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC US Pregnant Uterus W Detail Fetal Anatomy Sgl Fetus",
      "code_information": [
        {
          "code": "PX-40200014",
          "type": "CDM"
        },
        {
          "code": "76811",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 677,
          "discounted_cash": 440.05,
          "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": 434.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 434.63
            },
            {
              "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": 494.21
            },
            {
              "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": 216,
              "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": 677,
              "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": 677,
              "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": 575.45
            },
            {
              "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": 434.63
            },
            {
              "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": 213.87,
              "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": 507.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 575.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 427.86
            },
            {
              "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": 427.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 575.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 507.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 427.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 434.63
            },
            {
              "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": 218.23,
              "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": 595.76
            },
            {
              "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": 372.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 372.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 494.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 677,
              "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": 372.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 372.35
            },
            {
              "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": 224.56,
              "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": 677,
              "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": 575.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 494.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 575.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 434.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 555.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 555.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 575.45
            },
            {
              "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": 218.23,
              "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": 575.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 575.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 440.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 440.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 677
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 575.45
            },
            {
              "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": 213.87,
              "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": 547.69
            },
            {
              "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": 593.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 216,
              "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": 677,
              "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": 372.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 434.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 372.35
            },
            {
              "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": 440.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 555.14
            },
            {
              "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": 555.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 507.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 575.45
            },
            {
              "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": 218.23,
              "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": 427.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 561.23
            },
            {
              "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": 440.05
            },
            {
              "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": 593.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 494.21
            },
            {
              "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": 213.87,
              "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": 561.23
            },
            {
              "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": 434.63
            },
            {
              "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": 184.82
            },
            {
              "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": 216,
              "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": 427.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 575.45
            },
            {
              "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": 213.87,
              "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": 555.14
            },
            {
              "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": 555.14
            },
            {
              "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": 555.14
            },
            {
              "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": 427.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 677,
              "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": 224.56,
              "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": 427.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 375.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 555.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 375.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 494.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 494.21
            },
            {
              "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": 677,
              "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": 547.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 575.45
            },
            {
              "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": 434.63
            },
            {
              "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": 224.56,
              "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": 561.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 677,
              "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": 677,
              "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": 434.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 427.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 434.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 575.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 434.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 677,
              "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": 677,
              "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": 575.45
            },
            {
              "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": 677,
              "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": 375.74
            },
            {
              "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": 375.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 677,
              "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": 677,
              "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": 216,
              "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": 440.73
            },
            {
              "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": 677,
              "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": 440.73
            },
            {
              "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": 434.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 372.35
            },
            {
              "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": 216,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC US Prostate Volume Study for Brachytherapy Planning",
      "code_information": [
        {
          "code": "PX-40200035",
          "type": "CDM"
        },
        {
          "code": "76873",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 675,
          "discounted_cash": 438.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 433.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 433.35
            },
            {
              "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": 426.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 426.6
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 433.35
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 675,
              "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": 426.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 546.08
            },
            {
              "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": 553.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 426.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 594
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 426.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 374.63
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 506.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 433.35
            },
            {
              "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": 433.35
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 675,
              "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": 371.25
            },
            {
              "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": 433.35
            },
            {
              "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": 573.75
            },
            {
              "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": 426.6
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 591.98
            },
            {
              "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": 492.75
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "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": "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": "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": "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": "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": "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 [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 492.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 553.5
            },
            {
              "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": 374.63
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 573.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 433.35
            },
            {
              "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": 675,
              "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": 675,
              "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": 439.43
            },
            {
              "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": 553.5
            },
            {
              "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": 675,
              "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": 371.25
            },
            {
              "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": "UHC 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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 675,
              "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": 559.58
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 426.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 675,
              "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": 433.35
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 433.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "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": 553.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 371.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 433.35
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 433.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 433.35
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 439.43
            },
            {
              "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": 426.6
            },
            {
              "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": "HUMANA [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": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 675,
              "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": 374.63
            },
            {
              "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": "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": "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": "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
            }
          ]
        }
      ]
    },
    {
      "description": "HC US Extremity Complete Joint",
      "code_information": [
        {
          "code": "PX-40200036",
          "type": "CDM"
        },
        {
          "code": "76881",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 657,
          "discounted_cash": 427.05,
          "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": 421.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 415.22
            },
            {
              "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": 415.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 657,
              "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": 421.79
            },
            {
              "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": 364.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 415.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 415.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "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": 364.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 538.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 421.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 538.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 415.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 544.65
            },
            {
              "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": 421.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 538.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 427.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 657,
              "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": 427.05
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 657,
              "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": 538.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 657
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 544.65
            },
            {
              "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": 421.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 427.71
            },
            {
              "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": 538.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 421.79
            },
            {
              "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": 657,
              "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": 657,
              "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": 421.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 657,
              "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": 657,
              "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": 558.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 421.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 544.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 657,
              "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": 415.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 364.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 558.45
            },
            {
              "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": 538.74
            },
            {
              "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": 361.35
            },
            {
              "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": 415.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 531.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 427.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 479.61
            },
            {
              "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": 657,
              "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": 657,
              "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": 421.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 479.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "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": 421.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 179.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 657,
              "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": 479.61
            },
            {
              "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": 558.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 578.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 479.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 657,
              "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": 558.45
            },
            {
              "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": 531.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 492.75
            },
            {
              "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": 576.19
            },
            {
              "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": 427.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 538.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 538.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 479.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "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": 364.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 558.45
            },
            {
              "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": 657,
              "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": 421.79
            },
            {
              "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": 421.79
            },
            {
              "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": 576.19
            },
            {
              "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": 415.22
            },
            {
              "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": 427.71
            },
            {
              "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": 479.61
            }
          ]
        }
      ]
    },
    {
      "description": "Mouth Lip Moisturizer",
      "code_information": [
        {
          "code": "PX-CH-KC12262",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.54,
          "discounted_cash": 1.65,
          "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": 1.63
            },
            {
              "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": 2.54,
              "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": 2.54,
              "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": 1.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.63
            },
            {
              "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": 2.54,
              "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": 1.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 2.54,
              "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": 2.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.4
            },
            {
              "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": 2.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 2.54,
              "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": 2.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 2.54,
              "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": 1.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.05
            },
            {
              "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": 1.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 1.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.61
            },
            {
              "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": 1.61
            },
            {
              "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": 1.63
            },
            {
              "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": 2.54,
              "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": 1.41
            },
            {
              "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": 2.54,
              "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": 1.61
            },
            {
              "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": 2.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 2.54,
              "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": 1.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.4
            },
            {
              "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": 1.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.4
            },
            {
              "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": 2.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.4
            },
            {
              "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": 2.54,
              "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": 2.08
            },
            {
              "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": 2.08
            },
            {
              "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": 1.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.16
            },
            {
              "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": 1.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.61
            },
            {
              "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": 2.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 2.54,
              "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": 2.54,
              "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": 1.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.63
            },
            {
              "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": 2.54,
              "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": 2.54,
              "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": 2.54,
              "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": 2.54,
              "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": 2.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 2.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.65
            },
            {
              "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": 2.24
            },
            {
              "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": 2.54,
              "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": 2.54,
              "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": 2.54,
              "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": 2.54,
              "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": 2.08
            },
            {
              "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": 1.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 1.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 2.54,
              "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": 2.08
            },
            {
              "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": 2.54,
              "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": 2.54,
              "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": 2.08
            },
            {
              "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": 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": 0.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.54
            },
            {
              "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": 2.54,
              "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": 2.54,
              "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": 1.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.85
            },
            {
              "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": 2.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.63
            },
            {
              "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": 2.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.54,
              "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": 1.91
            },
            {
              "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": 1.41
            },
            {
              "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": 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": 2.54,
              "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": 2.54,
              "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": 2.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.91
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 3.78,
          "discounted_cash": 2.46,
          "payers_information": [
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.1
            },
            {
              "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": 2.1
            },
            {
              "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": 3.1
            },
            {
              "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": 3.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.39
            },
            {
              "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": 2.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 3.78,
              "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": 3.78,
              "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": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 3.78,
              "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": 2.76
            },
            {
              "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": 3.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 2.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 3.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 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": 3.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 2.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.43
            },
            {
              "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": 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": 2.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.78
            },
            {
              "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": 3.78,
              "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": 3.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.84
            },
            {
              "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": 2.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 3.13
            },
            {
              "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": 3.13
            },
            {
              "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": 2.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.08
            },
            {
              "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": 2.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 3.78,
              "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": 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": 2.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 3.78,
              "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": 3.78,
              "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": 2.76
            },
            {
              "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": 2.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.1
            },
            {
              "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": 3.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.43
            },
            {
              "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": 2.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.76
            },
            {
              "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": 2.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.06
            },
            {
              "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": 2.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 2.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.46
            },
            {
              "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": 2.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 2.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 2.43
            },
            {
              "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": 3.21
            },
            {
              "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": 1.03
            },
            {
              "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": 2.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 2.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.78,
              "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": 3.78,
              "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": 3.78,
              "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": 2.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pt Canalith Respositioning Proc",
      "code_information": [
        {
          "code": "PX-42000005",
          "type": "CDM"
        },
        {
          "code": "95992",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 304,
          "discounted_cash": 197.6,
          "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": 195.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.49,
              "estimated_amount": 34.49
            },
            {
              "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": 197.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 195.17
            },
            {
              "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": 195.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 252.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 228
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 304,
              "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": 195.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 258.4
            },
            {
              "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": 245.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 197.9
            },
            {
              "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": 249.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 221.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.83,
              "additional_payer_notes": "PHYSICIAN 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": 304,
              "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": 304,
              "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": 192.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.49,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 34.49,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.83,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 258.4
            },
            {
              "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": 167.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.83,
              "additional_payer_notes": "PHYSICIAN 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": 192.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 245.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 304,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 228
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 304,
              "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": 304,
              "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": 192.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 249.28
            },
            {
              "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": 304,
              "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": 304
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 252.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.13
            },
            {
              "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": 168.72
            },
            {
              "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": 252.02
            },
            {
              "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": 304,
              "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": 249.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.49,
              "estimated_amount": 34.49
            },
            {
              "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": 197.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.28
            },
            {
              "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": 304,
              "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": 266.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.49,
              "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": 168.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "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": 258.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.17
            },
            {
              "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": 304,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.49,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "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": 168.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.17
            },
            {
              "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": 195.17
            },
            {
              "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": 82.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 228
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "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": 197.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 258.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 168.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "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": 192.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 304,
              "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": 304,
              "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": 304,
              "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": 258.4
            },
            {
              "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": 221.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 197.9
            },
            {
              "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": 266.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.49,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.92
            },
            {
              "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": 267.52
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.83,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.21,
              "additional_payer_notes": "PHYSICIAN 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": 195.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 197.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.83,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.21,
              "additional_payer_notes": "PHYSICIAN 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": 195.17
            },
            {
              "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": 249.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 258.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.17
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 34.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.21,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            }
          ],
          "minimum": 34.49,
          "maximum": 34.49
        }
      ]
    },
    {
      "description": "Pt Exercise Therapeutic 15 Min",
      "code_information": [
        {
          "code": "PX-42000018",
          "type": "CDM"
        },
        {
          "code": "97110",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 193,
          "discounted_cash": 125.45,
          "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": 123.91
            },
            {
              "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": 156.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 193,
              "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": 123.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 160
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 125.64
            },
            {
              "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": 52.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 107.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 193,
              "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": 28.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 193,
              "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": 106.15
            },
            {
              "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": 121.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 158.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 144.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "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": 123.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 106.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 160
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 121.98
            },
            {
              "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": 29.46
            },
            {
              "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": 121.98
            },
            {
              "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": 28.06
            },
            {
              "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": 28.06
            },
            {
              "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": 193,
              "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": 125.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 158.26
            },
            {
              "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": 106.15
            },
            {
              "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": 28.06
            },
            {
              "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": 193,
              "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": 107.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 158.26
            },
            {
              "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": 123.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 123.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 158.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "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": 28.06
            },
            {
              "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": 193,
              "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": 164.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 106.15
            },
            {
              "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": 32.01
            },
            {
              "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": 193,
              "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": 164.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 125.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 144.75
            },
            {
              "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": 140.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 164.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 106.15
            },
            {
              "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": 28.06
            },
            {
              "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": 107.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 158.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "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": 193,
              "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": 193,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 156.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 106.15
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 193,
              "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": 158.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 121.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 164.05
            },
            {
              "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": 164.05
            },
            {
              "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": 121.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 125.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 106.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 144.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.98
            },
            {
              "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": 125.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.91
            },
            {
              "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": 158.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 164.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 140.89
            },
            {
              "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": 125.64
            },
            {
              "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": 164.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 28.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 193
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 107.12
            },
            {
              "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": 123.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.91
            },
            {
              "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": 160
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 169.26
            },
            {
              "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": 158.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 193,
              "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": 193,
              "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_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": 28.06
            },
            {
              "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": 169.26
            },
            {
              "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": 28.06
            },
            {
              "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": 169.84
            },
            {
              "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": 28.06
            }
          ]
        }
      ]
    },
    {
      "description": "Pt Sensory Integration 15 Min",
      "code_information": [
        {
          "code": "PX-42000026",
          "type": "CDM"
        },
        {
          "code": "97533",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 161,
          "discounted_cash": 104.65,
          "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": 103.36
            },
            {
              "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": 136.85
            },
            {
              "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": 104.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 161
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 133.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "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": 104.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 104.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "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": 136.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 136.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 130.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 104.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 120.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 89.36
            },
            {
              "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": 101.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "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": 89.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "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": 130.25
            },
            {
              "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": 161,
              "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": 132.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "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": 141.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 101.75
            },
            {
              "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": 161,
              "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": 161,
              "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": 103.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "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": 43.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "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": 161,
              "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": 161,
              "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": 103.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "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": 104.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 136.85
            },
            {
              "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": 88.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "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": 133.47
            },
            {
              "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": 101.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "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": 132.02
            },
            {
              "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": 89.36
            },
            {
              "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": 141.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 136.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "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": 132.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 133.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "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": 103.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161,
              "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": 120.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 103.36
            },
            {
              "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": 103.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 89.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161,
              "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": 161,
              "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": 136.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 104.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 120.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 101.75
            },
            {
              "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": 132.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 161,
              "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": 117.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 101.75
            },
            {
              "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": 161,
              "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": 141.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Derma Dry Bariatric Xxlg 63in - 70in Attends",
      "code_information": [
        {
          "code": "PX-CH-IMCDD50",
          "type": "CDM"
        },
        {
          "code": "T4524",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.51,
          "discounted_cash": 0.98,
          "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": 0.97
            },
            {
              "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": 0.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 1.25
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.51,
              "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": 1.24
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.97
            },
            {
              "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": 1.24
            },
            {
              "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": 0.84
            },
            {
              "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": 1.24
            },
            {
              "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": 1.51,
              "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": 1.51
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.28
            },
            {
              "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": 1.51,
              "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": 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": 1.25
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.1
            },
            {
              "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": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 0.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.22
            },
            {
              "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": "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": "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.32
            },
            {
              "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": 1.33
            },
            {
              "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 STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 1.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.24
            },
            {
              "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.28
            },
            {
              "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": 1.51,
              "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": 0.95
            },
            {
              "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": 0.98
            },
            {
              "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": 1.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.51,
              "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": 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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 0.98
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "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": 0.41
            },
            {
              "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": 0.97
            },
            {
              "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": 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": 1.51,
              "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": 1.51,
              "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": 1.28
            },
            {
              "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": 0.98
            },
            {
              "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": "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": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 1.24
            },
            {
              "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
            }
          ]
        }
      ]
    },
    {
      "description": "Slipper Socks Med Blue Terrycloth",
      "code_information": [
        {
          "code": "PX-CH-A1-85125-BLU",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.94,
          "discounted_cash": 0.61,
          "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": 0.6
            },
            {
              "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": 0.6
            },
            {
              "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": 0.69
            },
            {
              "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": 0.94,
              "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": 0.94,
              "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": 0.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "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": 0.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.6
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.94,
              "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": 0.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.69
            },
            {
              "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": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.52
            },
            {
              "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": 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": 0.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "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": 0.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.8
            },
            {
              "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": 0.6
            },
            {
              "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": 0.52
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.6
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.94,
              "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": 0.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.52
            },
            {
              "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": 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": 0.94,
              "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": 0.94,
              "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": 0.8
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "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": 0.94,
              "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": 0.94,
              "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": 0.6
            },
            {
              "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": 0.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "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": 0.26
            },
            {
              "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": 0.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.8
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.52
            },
            {
              "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": 0.52
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.94,
              "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": 0.71
            },
            {
              "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": 0.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.94,
              "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": 0.94,
              "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": 0.52
            },
            {
              "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": 0.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.78
            }
          ]
        }
      ]
    },
    {
      "description": "HC Endvsc Rep Infrnl Aort/Ilc Art by Aorto-Uni-Ilc Endgrft Not Rupt W Img",
      "code_information": [
        {
          "code": "PX-36100894",
          "type": "CDM"
        },
        {
          "code": "34703",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 44303,
          "discounted_cash": 28796.95,
          "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": 28442.53
            },
            {
              "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": 44303,
              "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": 27999.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 44303,
              "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": 28442.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28841.25
            },
            {
              "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": 36328.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37657.55
            },
            {
              "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": 32341.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24366.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37657.55
            },
            {
              "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": 28442.53
            },
            {
              "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": 37657.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27999.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 37657.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24366.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32341.19
            },
            {
              "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": 28841.25
            },
            {
              "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": 38986.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37657.55
            },
            {
              "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": 27999.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 33227.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32341.19
            },
            {
              "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": 27999.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28442.53
            },
            {
              "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": 36328.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28442.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28841.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32341.19
            },
            {
              "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": 38853.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24366.65
            },
            {
              "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": 37657.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36727.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 44303,
              "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": 44303,
              "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": 44303,
              "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": 32341.19
            },
            {
              "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": 27999.5
            },
            {
              "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": 44303,
              "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": 37657.55
            },
            {
              "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": 28442.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24366.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36727.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36328.46
            },
            {
              "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": 44303,
              "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": 37657.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 28442.53
            },
            {
              "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": 36328.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37657.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27999.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 44303,
              "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": 28442.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35841.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28841.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36328.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37657.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27999.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28442.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 12094.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 28442.53
            },
            {
              "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": 35841.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 44303,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36328.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24366.65
            },
            {
              "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": 36727.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 33227.25
            },
            {
              "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": 28796.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37657.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36328.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44303,
              "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": 27999.5
            },
            {
              "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": 44303,
              "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": 44303,
              "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": 44303,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28442.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24366.65
            },
            {
              "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": 24366.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32341.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28442.53
            },
            {
              "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": 28841.25
            },
            {
              "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": 38853.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37657.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33227.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 44303,
              "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": 36328.46
            }
          ]
        }
      ]
    },
    {
      "description": "HC I and D Vulva or Perineal Abscess",
      "code_information": [
        {
          "code": "PX-45000018",
          "type": "CDM"
        },
        {
          "code": "56405",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1864,
          "discounted_cash": 1211.6,
          "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": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "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": 1025.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "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": 1364.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.72
            },
            {
              "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": 1371.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1545.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "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": 1170.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1364.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.74
            },
            {
              "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": 1211.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1025.2
            },
            {
              "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": 1370.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "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": 1360.72
            },
            {
              "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": 1584.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "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": 1864,
              "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": 1170.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1025.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "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": 1528.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "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": 1170.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1545.26
            },
            {
              "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": 1170.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1398
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "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": 1370.04
            },
            {
              "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": 1507.98
            },
            {
              "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": 1213.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1213.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "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": 1634.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1864
            },
            {
              "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": 1371.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1213.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1528.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1528.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1025.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1025.2
            },
            {
              "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": 1864,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1364.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "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": 1213.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1528.48
            },
            {
              "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": 1528.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.72
            },
            {
              "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": 1634.73
            },
            {
              "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": 1370.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1025.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1370.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "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": 1640.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1364.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "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": 1864,
              "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": 1398
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1364.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.74
            },
            {
              "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": 1528.48
            },
            {
              "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": 1545.26
            },
            {
              "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": 1364.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1528.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1364.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1507.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1864,
              "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": 1864,
              "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": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            },
            {
              "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": 508.87
            },
            {
              "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": 1584.4
            },
            {
              "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": 1364.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1528.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1398
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1025.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.72
            },
            {
              "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": 1371.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1213.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1584.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC Apply Casts Lower Ext",
      "code_information": [
        {
          "code": "PX-45000043",
          "type": "CDM"
        },
        {
          "code": "45000043",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1549,
          "discounted_cash": 1006.85,
          "payers_information": [
            {
              "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": 1140.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 851.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "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": 1138.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "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": 422.88
            },
            {
              "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": 1284.12
            },
            {
              "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": 1133.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1005.3
            },
            {
              "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": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "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": 1549,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "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": 1138.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 851.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1549,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "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": 1140.06
            },
            {
              "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": 1008.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1133.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1005.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1130.77
            },
            {
              "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": 1133.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 851.95
            },
            {
              "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": 1270.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1284.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "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": 1270.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1130.77
            },
            {
              "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": 1316.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1133.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1005.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1253.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1270.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1270.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "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": 972.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1130.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "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": 1138.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1549,
              "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": 972.77
            },
            {
              "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": 1358.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1270.18
            },
            {
              "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": 1008.4
            },
            {
              "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": 1358.47
            },
            {
              "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": 972.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1008.4
            },
            {
              "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": 1006.85
            },
            {
              "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": 1270.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "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": 1363.12
            },
            {
              "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": 1140.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1270.18
            },
            {
              "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": 1130.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 851.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 851.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1130.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1140.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1270.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1161.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "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": 1316.65
            },
            {
              "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": 851.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1008.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 851.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1161.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1133.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1284.12
            },
            {
              "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": 1140.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1130.77
            },
            {
              "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": 1549,
              "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": 1549
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1316.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1138.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "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": 972.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1133.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1133.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1005.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1008.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1161.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "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": 1253.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 972.77
            },
            {
              "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": 1133.87
            },
            {
              "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": 1549,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tx Fx Dislocation WO Anesthesia",
      "code_information": [
        {
          "code": "PX-45000050",
          "type": "CDM"
        },
        {
          "code": "45000050",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 948,
          "discounted_cash": 616.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 697.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 697.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 521.4
            },
            {
              "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": 692.04
            },
            {
              "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": 948,
              "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": 595.34
            },
            {
              "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": 73.6,
              "estimated_amount": 697.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 692.04
            },
            {
              "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": 697.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 692.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 697.73
            },
            {
              "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": 777.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 785.89
            },
            {
              "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": 617.15
            },
            {
              "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": 696.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 948
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "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": 696.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 693.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 692.04
            },
            {
              "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": 948,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 697.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 693.94
            },
            {
              "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": 693.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "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": 521.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 766.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 615.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 948,
              "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": 73.6,
              "estimated_amount": 697.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 693.94
            },
            {
              "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": 616.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "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": 766.93
            },
            {
              "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": 258.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 615.25
            },
            {
              "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": 696.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 693.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 697.73
            },
            {
              "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": 595.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 615.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 777.36
            },
            {
              "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": 595.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 711
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 615.25
            },
            {
              "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": 948,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 697.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 805.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 696.78
            },
            {
              "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": 834.24
            },
            {
              "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": 697.73
            },
            {
              "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": 785.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 777.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 617.15
            },
            {
              "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": 777.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 692.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 711
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 711
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "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": 693.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 777.36
            },
            {
              "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": 948,
              "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": 617.15
            },
            {
              "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": 693.94
            },
            {
              "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": 831.4
            },
            {
              "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": 595.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "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": 697.73
            },
            {
              "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": 805.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 692.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 617.15
            },
            {
              "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": 831.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 805.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 693.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 595.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 617.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 777.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 777.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 785.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 697.73
            },
            {
              "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": 777.36
            }
          ]
        }
      ]
    },
    {
      "description": "HC Trim of Nondystrophic Nails",
      "code_information": [
        {
          "code": "PX-45000051",
          "type": "CDM"
        },
        {
          "code": "11719",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 187,
          "discounted_cash": 121.55,
          "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": 73.6,
              "estimated_amount": 137.63
            },
            {
              "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": 153.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 102.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 136.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 155.02
            },
            {
              "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": 53.92,
              "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": 187,
              "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": 187,
              "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": 102.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 158.95
            },
            {
              "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": 136.51
            },
            {
              "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": 187,
              "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": 73.5,
              "estimated_amount": 137.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.85
            },
            {
              "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": 121.55
            },
            {
              "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": 158.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.51
            },
            {
              "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": 53.39,
              "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": 153.34
            },
            {
              "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
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 155.02
            },
            {
              "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": 187,
              "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": 53.39,
              "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": 73.2,
              "estimated_amount": 136.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.85
            },
            {
              "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": 137.63
            },
            {
              "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": 187,
              "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": 54.48,
              "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": 153.34
            },
            {
              "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": 155.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 137.63
            },
            {
              "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": 137.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.34
            },
            {
              "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": 51.05
            },
            {
              "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": 56.06,
              "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": 102.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 73.6,
              "estimated_amount": 137.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 187,
              "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": 136.51
            },
            {
              "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": 53.92,
              "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": 136.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.95
            },
            {
              "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": 187,
              "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": 53.92,
              "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": 73.2,
              "estimated_amount": 136.88
            },
            {
              "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": 54.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 137.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.39,
              "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": 140.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 102.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 187,
              "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": 187,
              "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": 73.6,
              "estimated_amount": 137.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 187
            },
            {
              "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": 53.39,
              "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": 53.39,
              "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": 158.95
            },
            {
              "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": 151.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.85
            },
            {
              "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": 187,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 136.88
            },
            {
              "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": 53.92,
              "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": 136.51
            },
            {
              "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": 53.39,
              "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": 137.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 187,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 137.63
            },
            {
              "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": 137.63
            },
            {
              "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": 137.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.95
            },
            {
              "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": 187,
              "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": 164.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 137.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 151.28
            },
            {
              "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": 121.74
            },
            {
              "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": 121.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 56.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 137.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 140.25
            },
            {
              "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": 136.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 136.88
            },
            {
              "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": 54.48,
              "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": 153.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 136.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 137.63
            },
            {
              "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": 164
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 187,
              "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": 53.92,
              "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": 158.95
            },
            {
              "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": 137.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.06,
              "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": 158.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.74
            },
            {
              "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": 136.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.95
            }
          ]
        }
      ]
    },
    {
      "description": "Idh2 , Common Variants Sendout",
      "code_information": [
        {
          "code": "PX-30101278",
          "type": "CDM"
        },
        {
          "code": "81121",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1029,
          "discounted_cash": 668.85,
          "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": 660.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 660.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 751.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 853.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.79,
              "estimated_amount": 295.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1029
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.79,
              "estimated_amount": 295.79
            },
            {
              "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": 225.35
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 310.58,
              "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": 843.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 843.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 751.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 310.58,
              "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": 571.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 660.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 660.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 650.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.79,
              "estimated_amount": 295.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.79,
              "estimated_amount": 295.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 905.52
            },
            {
              "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": 874.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 751.17
            },
            {
              "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": 751.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "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": 660.62
            },
            {
              "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": 669.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 669.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 843.78
            },
            {
              "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": 650.33
            },
            {
              "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": 660.62
            },
            {
              "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": 843.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 298.75,
              "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": 843.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 650.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 660.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 669.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 832.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 669.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 843.78
            },
            {
              "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": 874.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 650.33
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 565.95
            },
            {
              "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": 565.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 571.1
            },
            {
              "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": 1029,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 298.75,
              "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": 874.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 771.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 1029,
              "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": 660.62
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.79,
              "estimated_amount": 295.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 771.75
            },
            {
              "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": 832.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 571.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "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": 280.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 298.75,
              "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": 771.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "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": 902.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 565.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 298.75,
              "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": 902.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 660.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 650.33
            },
            {
              "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": 650.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 565.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 751.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 853.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 565.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 843.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "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": 660.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 660.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 853.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 298.75,
              "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": 1029,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 295.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 310.58,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1109.21,
              "estimated_amount": 1109.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 565.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 751.17
            },
            {
              "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": 1029,
              "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": 668.85
            },
            {
              "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": 669.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.79,
              "estimated_amount": 295.79
            },
            {
              "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": 650.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 874.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 650.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.79,
              "estimated_amount": 295.79
            },
            {
              "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": 571.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 565.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 660.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1029,
              "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": 843.78
            }
          ],
          "minimum": 295.79,
          "maximum": 1109.21
        }
      ]
    },
    {
      "description": "Oxygen Tubing 7 Ft Standard",
      "code_information": [
        {
          "code": "PX-CH-55001330",
          "type": "CDM"
        },
        {
          "code": "A4616",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.98,
          "discounted_cash": 0.64,
          "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": 0.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "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": 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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.64
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "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": 0.64
            },
            {
              "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": 0.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "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": 0.98,
              "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": 0.98,
              "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": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.64
            },
            {
              "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": 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": 0.74
            },
            {
              "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": 0.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.98,
              "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": 0.63
            },
            {
              "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": 0.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 0.81
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.98,
              "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": 0.63
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.62
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.63
            },
            {
              "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": 0.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.72
            },
            {
              "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": 0.98,
              "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": 0.98,
              "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": 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": 0.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.98,
              "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": 0.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.83
            },
            {
              "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": 0.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.64
            },
            {
              "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": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "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": 0.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "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": 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": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.64
            },
            {
              "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": 0.79
            },
            {
              "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": 0.98,
              "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": 0.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "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": 0.98,
              "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": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.98
            },
            {
              "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": 0.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            }
          ]
        }
      ]
    },
    {
      "description": "HC Appl Rigid Total Cont Leg Cast",
      "code_information": [
        {
          "code": "PX-45000177",
          "type": "CDM"
        },
        {
          "code": "29445",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2130,
          "discounted_cash": 1384.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1367.46
            },
            {
              "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": 234.39,
              "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": 1810.5
            },
            {
              "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": 245.73,
              "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": 2130,
              "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": 2130,
              "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": 1723.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1171.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 2130,
              "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": 1182.15
            },
            {
              "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": 1810.5
            },
            {
              "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": 236.74,
              "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": 1367.46
            },
            {
              "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": 1367.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1386.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1746.6
            },
            {
              "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": 1384.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "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": 1868.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 1182.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 236.74,
              "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": 245.73,
              "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": 1386.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2130,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1346.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 236.74,
              "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": 258.02,
              "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": 1386.63
            },
            {
              "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": 1874.4
            },
            {
              "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": 236.74,
              "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": 2130,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1367.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1367.46
            },
            {
              "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": 1386.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1346.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1597.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 250.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1182.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1765.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1554.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1746.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 2130,
              "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": 1810.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1171.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1554.9
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2130,
              "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": 1346.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "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": 581.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1171.5
            },
            {
              "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": 246.11,
              "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": 1367.46
            },
            {
              "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": 1723.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1171.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1367.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 1367.46
            },
            {
              "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": 1746.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1746.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1597.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1171.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1554.9
            },
            {
              "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": 2130,
              "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": 2130,
              "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": 2130,
              "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": 2130,
              "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": 1386.63
            },
            {
              "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": 1554.9
            },
            {
              "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": 1810.5
            },
            {
              "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": 246.11,
              "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": 1367.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1367.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 250.74,
              "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": 1810.5
            },
            {
              "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": 1367.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1367.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1746.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1346.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1171.5
            },
            {
              "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": 1346.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 1746.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1554.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1554.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1182.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2130
            },
            {
              "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": 2130,
              "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": 250.74,
              "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": 1810.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1810.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1765.77
            },
            {
              "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": 1346.16
            },
            {
              "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": 1746.6
            },
            {
              "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": 1171.5
            },
            {
              "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": 1346.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2130,
              "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": 1765.77
            },
            {
              "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": 1746.6
            },
            {
              "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": 1868.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1597.5
            },
            {
              "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": 234.39,
              "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": 1346.16
            },
            {
              "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": 236.74,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Spirometry Pft Simple",
      "code_information": [
        {
          "code": "PX-46000001",
          "type": "CDM"
        },
        {
          "code": "94010",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 751,
          "discounted_cash": 488.15,
          "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": 482.14
            },
            {
              "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": 482.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 482.14
            },
            {
              "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": 143.15,
              "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": 416.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "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": 474.63
            },
            {
              "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": 638.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 638.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "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": 205.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 751,
              "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": 638.35
            },
            {
              "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": 136.33,
              "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": 488.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 751,
              "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": 638.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 615.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "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": 548.23
            },
            {
              "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": 615.82
            },
            {
              "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": 136.33,
              "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": 413.05
            },
            {
              "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": 474.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 136.17,
              "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": 638.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 622.58
            },
            {
              "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": 660.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 413.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "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": 413.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "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": 136.17,
              "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": 416.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 488.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "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": 607.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 563.25
            },
            {
              "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": 136.17,
              "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": 474.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 136.33,
              "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": 622.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 751,
              "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": 482.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 607.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 563.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 413.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 548.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 751,
              "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": 751,
              "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": 474.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "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": 638.35
            },
            {
              "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": 143.15,
              "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": 137.7,
              "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": 488.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 548.23
            },
            {
              "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": 137.7,
              "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": 658.63
            },
            {
              "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": 751,
              "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": 751,
              "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": 482.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "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": 615.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 751,
              "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": 548.23
            },
            {
              "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": 751,
              "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": 751
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 416.81
            },
            {
              "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": 751,
              "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": 488.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "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": 136.33,
              "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": 413.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 548.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 548.23
            },
            {
              "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": 137.7,
              "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": 137.7,
              "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": 622.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "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": 751,
              "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": 150.07,
              "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": 413.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 413.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "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": 416.81
            },
            {
              "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": 137.7,
              "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": 638.35
            },
            {
              "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": 482.14
            },
            {
              "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": 615.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 563.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 488.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "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": 658.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 488.9
            },
            {
              "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": 482.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            }
          ]
        }
      ]
    },
    {
      "description": "HC Spirometry Pft Pre Post Bronchodilation",
      "code_information": [
        {
          "code": "PX-46000002",
          "type": "CDM"
        },
        {
          "code": "94060",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1518,
          "discounted_cash": 986.7,
          "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": 974.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1244.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 959.38
            },
            {
              "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": 273.63,
              "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": 1518,
              "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": 1518,
              "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": 1108.14
            },
            {
              "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": 276.69,
              "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": 974.56
            },
            {
              "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": 273.95,
              "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": 1518,
              "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": 1518,
              "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": 986.7
            },
            {
              "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": 1518,
              "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": 273.63,
              "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": 1258.42
            },
            {
              "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": 1518,
              "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": 959.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 1518,
              "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": 1290.3
            },
            {
              "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": 1518,
              "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": 273.95,
              "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": 1290.3
            },
            {
              "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": 834.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 834.9
            },
            {
              "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": 276.69,
              "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": 1258.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1138.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 974.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1244.76
            },
            {
              "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": 1244.76
            },
            {
              "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": 1244.76
            },
            {
              "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": 1331.29
            },
            {
              "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": 842.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1290.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1290.3
            },
            {
              "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": 276.69,
              "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": 988.22
            },
            {
              "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": 273.95,
              "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": 974.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 974.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 988.22
            },
            {
              "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": 1518,
              "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": 1290.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1138.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 959.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 276.69,
              "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": 1290.3
            },
            {
              "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": 1244.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1108.14
            },
            {
              "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": 974.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 959.38
            },
            {
              "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": 842.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 834.9
            },
            {
              "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": 287.65,
              "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": 1244.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 959.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1290.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1290.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 834.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1108.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 842.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 988.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1518
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1290.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 1290.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 974.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 273.63,
              "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": 1331.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 1518,
              "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": 974.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 974.56
            },
            {
              "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": 1290.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 834.9
            },
            {
              "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": 276.69,
              "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": 974.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 959.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1138.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1108.14
            },
            {
              "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": 959.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 1518,
              "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": 1518,
              "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": 1335.84
            },
            {
              "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": 974.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 974.56
            },
            {
              "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": 414.41
            },
            {
              "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": 988.22
            },
            {
              "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": 287.65,
              "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": 1108.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 834.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1518,
              "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": 332.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1228.06
            },
            {
              "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": 842.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1244.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1290.3
            },
            {
              "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": 959.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1518,
              "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": 273.95,
              "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": 1108.14
            },
            {
              "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": 1518,
              "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": 1290.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1258.42
            },
            {
              "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": 1228.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1244.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 834.9
            },
            {
              "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": 988.22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 287.65,
              "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": 1290.3
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 1 3/4 in Natura Invisclose",
      "code_information": [
        {
          "code": "PX-CH-CV4164-18",
          "type": "CDM"
        },
        {
          "code": "A5063",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.41,
          "discounted_cash": 2.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.43
            },
            {
              "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": 2.45
            },
            {
              "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": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 4.41,
              "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": 2.45
            },
            {
              "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": 2.87
            },
            {
              "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": 4.41,
              "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": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 4.41,
              "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": 3.75
            },
            {
              "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": 3.75
            },
            {
              "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": 4.41,
              "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": 2.83
            },
            {
              "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": 2.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.87
            },
            {
              "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": 1.2
            },
            {
              "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": 3.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.43
            },
            {
              "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": 3.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 4.41,
              "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": 3.66
            },
            {
              "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": 4.41,
              "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": 3.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.83
            },
            {
              "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": 2.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.41,
              "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": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 2.43
            },
            {
              "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": 2.79
            },
            {
              "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": 2.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 4.41,
              "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": 4.41,
              "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": 3.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.66
            },
            {
              "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": 4.41,
              "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": 4.41,
              "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": 4.41,
              "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": 2.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.75
            },
            {
              "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": 4.41,
              "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": 2.45
            },
            {
              "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": 2.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 4.41,
              "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": 4.41,
              "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": 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": 3.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.41
            },
            {
              "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": 4.41,
              "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": 2.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 3.75
            },
            {
              "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": 3.22
            },
            {
              "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": 4.41,
              "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": 2.79
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.41,
              "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": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 2.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.41,
              "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": 3.62
            },
            {
              "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": 3.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.75
            },
            {
              "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": 4.41,
              "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": 2.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.22
            },
            {
              "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": 4.41,
              "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": 3.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.31
            },
            {
              "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": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.41,
              "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": 4.41,
              "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": 3.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.87
            },
            {
              "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": 4.41,
              "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": 4.41,
              "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": 2.43
            },
            {
              "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": 2.83
            },
            {
              "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": 4.41,
              "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": 3.75
            },
            {
              "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": 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": 2.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 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": 3.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.22
            },
            {
              "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": 4.41,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Program Device Eval Dual Defib",
      "code_information": [
        {
          "code": "PX-48000011",
          "type": "CDM"
        },
        {
          "code": "93283",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 310,
          "discounted_cash": 201.5,
          "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": 199.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 310,
              "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": 64.2,
              "estimated_amount": 199.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 201.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "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": 33.24,
              "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": 199.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 310
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 310,
              "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": 263.5
            },
            {
              "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": 310,
              "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": 201.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 34.56,
              "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": 172.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 263.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 172.05
            },
            {
              "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": 310,
              "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": 232.5
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 199.02
            },
            {
              "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": 254.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 226.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "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": 34.56,
              "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": 32.91,
              "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": 32.91,
              "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": 170.5
            },
            {
              "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": 263.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "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": 263.5
            },
            {
              "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": 201.81
            },
            {
              "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": 33.24,
              "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": 195.92
            },
            {
              "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": 254.2
            },
            {
              "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": 34.56,
              "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": 33.58,
              "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": 226.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 310,
              "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": 201.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 250.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 256.99
            },
            {
              "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": 310,
              "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": 271.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 254.2
            },
            {
              "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": 254.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 226.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 226.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "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": 199.02
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 33.24,
              "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": 33.58,
              "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": 256.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 263.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 256.99
            },
            {
              "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": 271.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 170.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 84.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 310,
              "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": 32.91,
              "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": 172.05
            },
            {
              "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": 33.24,
              "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": 170.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 310,
              "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": 263.5
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 201.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 232.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 232.5
            },
            {
              "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": 32.91,
              "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": 172.05
            },
            {
              "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": 195.92
            },
            {
              "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": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 33.24,
              "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": 310,
              "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": 310,
              "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": 226.3
            },
            {
              "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": 201.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 310,
              "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": 195.92
            },
            {
              "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": 33.58,
              "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": 226.3
            },
            {
              "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": 250.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 272.8
            }
          ]
        }
      ]
    },
    {
      "description": "HC Intra Atrial Pacing",
      "code_information": [
        {
          "code": "PX-48000028",
          "type": "CDM"
        },
        {
          "code": "93610",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6294,
          "discounted_cash": 4091.1,
          "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": 4040.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5161.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5349.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4720.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3977.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 5161.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3461.7
            },
            {
              "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": 6294,
              "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": 5349.9
            },
            {
              "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": 6651.14,
              "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": 6294,
              "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": 5519.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4040.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 6294,
              "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": 6294,
              "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": 4040.75
            },
            {
              "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": 4040.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3493.17
            },
            {
              "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": 5091.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 5349.9
            },
            {
              "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": 6844.02,
              "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": 6294,
              "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": 4040.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5161.08
            },
            {
              "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": 4097.39
            },
            {
              "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": 5217.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 6844.02,
              "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": 5217.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 5349.9
            },
            {
              "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": 5538.72
            },
            {
              "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": 5349.9
            },
            {
              "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": 6518.12,
              "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": 6583.3,
              "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": 3977.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 4040.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 4594.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5349.9
            },
            {
              "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": 3493.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6294,
              "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": 4097.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5349.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3461.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4040.75
            },
            {
              "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": 5161.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5217.73
            },
            {
              "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": 3977.81
            },
            {
              "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": 4091.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 4097.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 6294,
              "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": 3977.81
            },
            {
              "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": 6844.02,
              "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": 3461.7
            },
            {
              "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": 4594.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3977.81
            },
            {
              "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": 3493.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3461.7
            },
            {
              "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": 3461.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4594.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 4040.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4720.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5349.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4594.62
            },
            {
              "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": 6583.3,
              "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": 6651.14,
              "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": 5349.9
            },
            {
              "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": 3977.81
            },
            {
              "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": 4040.75
            },
            {
              "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": 4040.75
            },
            {
              "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": 4040.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4097.39
            },
            {
              "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": 6518.12,
              "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": 3461.7
            },
            {
              "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": 5161.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5349.9
            },
            {
              "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": 6583.3,
              "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": 6294,
              "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": 1718.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4594.62
            },
            {
              "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": 6583.3,
              "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": 5349.9
            },
            {
              "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": 5519.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5349.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5161.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5091.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4097.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4040.75
            },
            {
              "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": 3493.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5349.9
            },
            {
              "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": 1378.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 5349.9
            },
            {
              "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": 6518.12,
              "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": 6294
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6294,
              "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": 6583.3,
              "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": 6518.12,
              "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": 5161.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3461.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4594.62
            },
            {
              "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": 3977.81
            },
            {
              "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": 5161.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 6651.14,
              "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": 3977.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6294,
              "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": 4720.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Analysis Icd Lead Generator at Implant",
      "code_information": [
        {
          "code": "PX-48000039",
          "type": "CDM"
        },
        {
          "code": "93641",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4815,
          "discounted_cash": 3129.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3091.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3134.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3948.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "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": 1054.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3091.23
            },
            {
              "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": 4815,
              "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": 4815,
              "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": 4815,
              "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": 4815,
              "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": 4815,
              "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": 4815,
              "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": 4815,
              "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": 3948.3
            },
            {
              "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": 3134.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 4092.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 2672.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2648.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4815
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3091.23
            },
            {
              "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": 4815,
              "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": 3991.64
            },
            {
              "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": 3043.08
            },
            {
              "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": 3129.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3043.08
            },
            {
              "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": 4815,
              "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": 4815,
              "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": 4237.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2648.25
            },
            {
              "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": 4815,
              "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": 4815,
              "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": 3611.25
            },
            {
              "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": 4092.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3895.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3134.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3948.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4815,
              "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": 3611.25
            },
            {
              "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": 1314.5
            },
            {
              "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": 4815,
              "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": 4815,
              "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": 3043.08
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "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": 4815,
              "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": 4815,
              "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": 4092.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3091.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3091.23
            },
            {
              "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": 3895.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 3514.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4815,
              "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": 3091.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3948.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 4815,
              "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": 4815,
              "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": 2672.33
            },
            {
              "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": 3091.23
            },
            {
              "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": 4815,
              "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": 4815,
              "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": 4092.75
            },
            {
              "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": 3091.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2672.33
            },
            {
              "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": 2648.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3091.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3134.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 3514.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3043.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3948.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3514.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3514.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4815,
              "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": 3091.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 4815,
              "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": 4092.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "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": 4815,
              "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": 3611.25
            },
            {
              "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": 3043.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4092.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2648.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2648.25
            },
            {
              "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": 4222.76
            },
            {
              "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": 4222.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3043.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 3991.64
            },
            {
              "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": 3091.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3514.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3043.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2648.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3091.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3948.3
            },
            {
              "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": 3948.3
            },
            {
              "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": 2672.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3991.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 4815,
              "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": 3514.95
            },
            {
              "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": 4815,
              "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": 2648.25
            },
            {
              "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": 4815,
              "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": 3134.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3948.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4815,
              "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": 4092.75
            },
            {
              "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": 3043.08
            }
          ]
        }
      ]
    },
    {
      "description": "HC Strapping Lower Extremity",
      "code_information": [
        {
          "code": "PX-51000001",
          "type": "CDM"
        },
        {
          "code": "29540",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1312,
          "discounted_cash": 852.8,
          "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": 842.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1075.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 842.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 842.3
            },
            {
              "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": 1061.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1075.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1312,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 728.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            },
            {
              "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": 1154.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 957.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 957.76
            },
            {
              "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": 1312,
              "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": 138.9,
              "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": 64.2,
              "estimated_amount": 842.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1075.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 1115.2
            },
            {
              "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": 1075.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 1312,
              "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": 1115.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 957.76
            },
            {
              "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": 137.52,
              "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": 138.9,
              "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": 137.52,
              "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": 984
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1087.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1075.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 721.6
            },
            {
              "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": 721.6
            },
            {
              "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": 1075.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "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": 842.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 721.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 721.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.08,
              "estimated_amount": 71.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 144.4,
              "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": 728.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 721.6
            },
            {
              "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": 144.4,
              "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": 1115.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 721.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "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": 842.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1061.41
            },
            {
              "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": 1312,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 854.11
            },
            {
              "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": 842.3
            },
            {
              "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": 854.11
            },
            {
              "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": 1075.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 957.76
            },
            {
              "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": 140.33,
              "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": 140.33,
              "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": 1087.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 842.3
            },
            {
              "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": 728.16
            },
            {
              "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": 358.18
            },
            {
              "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": 138.9,
              "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": 728.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 854.11
            },
            {
              "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": 854.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 1115.2
            },
            {
              "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": 137.52,
              "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": 1312,
              "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": 137.52,
              "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": 1312,
              "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": 1312
            },
            {
              "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": 1312,
              "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": 1312,
              "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": 854.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "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": 1312,
              "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": 721.6
            },
            {
              "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": 138.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.08,
              "estimated_amount": 71.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 1115.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 984
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 957.76
            },
            {
              "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": 1312,
              "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": 842.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 842.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1075.84
            },
            {
              "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": 842.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 842.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 957.76
            },
            {
              "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": 852.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            },
            {
              "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": 144.4,
              "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": 1087.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1115.2
            },
            {
              "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": 138.9,
              "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": 1115.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 984
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1312,
              "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": 140.33,
              "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": 1312,
              "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": 1312,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.38,
              "estimated_amount": 35.38
            }
          ],
          "minimum": 35.38,
          "maximum": 71.08
        }
      ]
    },
    {
      "description": "HC MRI Chest WO Contrast",
      "code_information": [
        {
          "code": "PX-61400001",
          "type": "CDM"
        },
        {
          "code": "71550",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1715,
          "discounted_cash": 1114.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "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": 1262.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1406.3
            },
            {
              "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": 213.87,
              "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": 1255.38
            },
            {
              "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": 1255.38
            },
            {
              "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": 1260.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 943.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1387.44
            },
            {
              "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": 1715,
              "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": 73.2,
              "estimated_amount": 1255.38
            },
            {
              "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": 1509.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 943.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1251.95
            },
            {
              "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": 216,
              "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": 1421.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1255.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1715,
              "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": 943.25
            },
            {
              "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": 224.56,
              "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": 1715,
              "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": 218.23,
              "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": 218.23,
              "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": 1715,
              "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": 1715,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "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": 1116.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1116.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "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": 224.56,
              "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": 1715,
              "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": 1457.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "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": 213.87,
              "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": 1715,
              "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": 1116.47
            },
            {
              "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": 213.87,
              "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": 1286.25
            },
            {
              "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": 216,
              "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": 1715,
              "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": 1116.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1116.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1406.3
            },
            {
              "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": 468.2
            },
            {
              "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": 218.23,
              "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": 1457.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1715,
              "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": 1715,
              "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": 1260.53
            },
            {
              "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": 1406.3
            },
            {
              "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": 1406.3
            },
            {
              "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": 1457.75
            },
            {
              "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": 1715,
              "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": 1504.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1715,
              "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": 1457.75
            },
            {
              "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": 216,
              "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": 1715,
              "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": 1715,
              "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": 1262.24
            },
            {
              "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": 1255.38
            },
            {
              "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": 1421.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1255.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1255.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1715,
              "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": 943.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1251.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1715,
              "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": 1457.75
            },
            {
              "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": 1262.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1286.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1406.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 943.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1286.25
            },
            {
              "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": 1406.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1406.3
            },
            {
              "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": 1251.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1251.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1251.95
            },
            {
              "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": 216,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1260.53
            },
            {
              "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": 1260.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1421.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1255.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1251.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1457.75
            },
            {
              "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": 213.87,
              "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": 1715,
              "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": 943.25
            },
            {
              "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": 1715,
              "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": 1715,
              "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": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "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": 224.56,
              "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": 216,
              "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": 1387.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1406.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1715,
              "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": 1504.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1262.24
            },
            {
              "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": 1114.75
            },
            {
              "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": 1262.24
            },
            {
              "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": 375.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1715,
              "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": 1715,
              "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": 1457.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1715
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 943.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Upper Ext Non Joint W Contrast",
      "code_information": [
        {
          "code": "PX-61400008",
          "type": "CDM"
        },
        {
          "code": "73219",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1976,
          "discounted_cash": 1284.4,
          "payers_information": [
            {
              "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": 1454.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1679.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1679.6
            },
            {
              "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": 1452.36
            },
            {
              "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": 1976,
              "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": 1679.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 335.65,
              "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": 1976,
              "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": 1638.1
            },
            {
              "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": 339.01,
              "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": 73.2,
              "estimated_amount": 1446.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1446.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1286.38
            },
            {
              "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": 342.5,
              "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": 1738.88
            },
            {
              "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": 432.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1086.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1679.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1679.6
            },
            {
              "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": 352.43,
              "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": 1086.8
            },
            {
              "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": 1679.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1620.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1446.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1446.43
            },
            {
              "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": 1679.6
            },
            {
              "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": 1454.34
            },
            {
              "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": 1286.38
            },
            {
              "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": 352.43,
              "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": 1442.48
            },
            {
              "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": 335.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1452.36
            },
            {
              "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": 1442.48
            },
            {
              "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": 1452.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1976,
              "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": 73.2,
              "estimated_amount": 1446.43
            },
            {
              "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": 1446.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1976,
              "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": 1620.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1482
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1679.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1679.6
            },
            {
              "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": 1454.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1620.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1442.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1086.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1086.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1638.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1620.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1086.8
            },
            {
              "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": 1976,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 1976,
              "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": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "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": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "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": 1620.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1638.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 1732.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1286.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 352.43,
              "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": 1679.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "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": 1284.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1679.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1620.32
            },
            {
              "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": 1086.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1442.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 73.2,
              "estimated_amount": 1446.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1976
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 339.01,
              "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": 339.01,
              "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": 1482
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1598.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1976,
              "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": 335.65,
              "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": 1976,
              "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": 1679.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 1976,
              "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": 1976,
              "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": 1086.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1442.48
            },
            {
              "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": 335.65,
              "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": 1442.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1482
            },
            {
              "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": 1446.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 1679.6
            },
            {
              "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": 1620.32
            },
            {
              "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": 1454.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1620.32
            },
            {
              "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": 1452.36
            },
            {
              "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": 1976,
              "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": 339.01,
              "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": 73.6,
              "estimated_amount": 1454.34
            },
            {
              "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": 539.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 342.5,
              "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": 1286.38
            },
            {
              "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": 1598.58
            },
            {
              "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": 339.01,
              "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": 1286.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "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": 1976,
              "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": 342.5,
              "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": 1679.6
            },
            {
              "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": 1732.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1976,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Abdomen W WO Contrast",
      "code_information": [
        {
          "code": "PX-61400021",
          "type": "CDM"
        },
        {
          "code": "74183",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2715,
          "discounted_cash": 1764.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "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": 1998.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "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": 2307.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1987.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 1981.95
            },
            {
              "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": 2715,
              "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": 1981.95
            },
            {
              "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": 339.01,
              "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": 1767.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2196.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1995.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1493.25
            },
            {
              "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": 2715,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1987.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 2226.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "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": 342.5,
              "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": 335.65,
              "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": 2715,
              "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": 2715,
              "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": 1981.95
            },
            {
              "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": 2307.75
            },
            {
              "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": 1767.47
            },
            {
              "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": 2250.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "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": 1764.75
            },
            {
              "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": 2381.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 342.5,
              "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": 1493.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2250.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1981.95
            },
            {
              "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": 339.01,
              "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": 2715,
              "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": 1998.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2226.3
            },
            {
              "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": 1995.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 2307.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1987.38
            },
            {
              "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": 1998.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2250.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "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": 1995.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2036.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 2715,
              "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": 2715,
              "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": 2307.75
            },
            {
              "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": 2715,
              "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": 342.5,
              "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": 1981.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "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": 352.43,
              "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": 1998.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2226.3
            },
            {
              "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": 741.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1987.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1987.38
            },
            {
              "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": 2715,
              "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": 2715,
              "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": 2036.25
            },
            {
              "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": 594.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1767.47
            },
            {
              "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": 2196.44
            },
            {
              "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": 2226.3
            },
            {
              "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": 339.01,
              "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": 1767.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1767.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1493.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1493.25
            },
            {
              "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": 339.01,
              "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": 335.65,
              "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": 73.2,
              "estimated_amount": 1987.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2715
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2226.3
            },
            {
              "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": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 2307.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 2226.3
            },
            {
              "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": 2381.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 1493.25
            },
            {
              "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": 339.01,
              "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": 2226.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2226.3
            },
            {
              "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": 1987.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2307.75
            },
            {
              "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": 352.43,
              "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": 335.65,
              "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": 2307.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1981.95
            },
            {
              "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": 352.43,
              "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": 73.2,
              "estimated_amount": 1987.38
            },
            {
              "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": 1995.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2036.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1493.25
            },
            {
              "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": 2389.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2715,
              "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": 2715,
              "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": 1493.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1998.24
            },
            {
              "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": 335.65,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pacu Stage 2 Addl 15 Minutes",
      "code_information": [
        {
          "code": "PX-71000007",
          "type": "CDM"
        },
        {
          "code": "71000007",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 432,
          "discounted_cash": 280.8,
          "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": 277.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "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": 237.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 315.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 354.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 324
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 432,
              "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": 354.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 354.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 324
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "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": 281.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 315.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "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": 273.02
            },
            {
              "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": 378.86
            },
            {
              "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": 432,
              "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": 367.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 315.36
            },
            {
              "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": 354.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "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": 315.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 280.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "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": 367.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 281.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 358.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.6
            },
            {
              "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": 273.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 280.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "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": 239.76
            },
            {
              "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": 239.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 281.23
            },
            {
              "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": 273.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 358.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 280.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 281.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.02
            },
            {
              "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": 378.86
            },
            {
              "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": 271.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "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": 432,
              "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": 324
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 315.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "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": 380.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 239.76
            },
            {
              "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": 358.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "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": 277.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 349.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 354.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 354.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.02
            },
            {
              "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": 280.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 432,
              "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": 273.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "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": 354.24
            },
            {
              "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": 432,
              "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": 273.02
            },
            {
              "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": 367.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 271.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 280.37
            },
            {
              "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": 239.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 315.36
            },
            {
              "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": 349.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 432
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 354.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 367.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.02
            },
            {
              "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": 271.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 277.34
            },
            {
              "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": 277.34
            },
            {
              "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": 281.23
            },
            {
              "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": 117.94
            },
            {
              "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": 271.3
            }
          ]
        }
      ]
    },
    {
      "description": "HC Event Recording",
      "code_information": [
        {
          "code": "PX-73100002",
          "type": "CDM"
        },
        {
          "code": "93270",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 641,
          "discounted_cash": 416.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 641,
              "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": 641,
              "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": 544.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 32.91,
              "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": 562.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 641,
              "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": 641,
              "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": 544.85
            },
            {
              "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": 641,
              "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": 355.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 531.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.85
            },
            {
              "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": 33.24,
              "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": 411.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 33.58,
              "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": 467.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 467.93
            },
            {
              "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": 33.24,
              "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": 525.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.85
            },
            {
              "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": 417.29
            },
            {
              "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": 411.52
            },
            {
              "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": 518.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.29
            },
            {
              "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": 417.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.62
            },
            {
              "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": 562.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 544.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.62
            },
            {
              "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": 34.56,
              "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": 641,
              "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": 544.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 355.76
            },
            {
              "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": 531.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480.75
            },
            {
              "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": 416.65
            },
            {
              "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": 641,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 641
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 411.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.62
            },
            {
              "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": 32.91,
              "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": 355.76
            },
            {
              "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": 467.93
            },
            {
              "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": 641,
              "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": 641,
              "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": 564.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.55
            },
            {
              "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": 352.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 525.62
            },
            {
              "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": 33.24,
              "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": 33.24,
              "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": 33.24,
              "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": 525.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 518.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 531.39
            },
            {
              "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": 641,
              "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": 411.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.52
            },
            {
              "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": 405.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 352.55
            },
            {
              "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": 405.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.11
            },
            {
              "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": 405.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 467.93
            },
            {
              "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": 34.56,
              "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": 544.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.55
            },
            {
              "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": 32.91,
              "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": 63.2,
              "estimated_amount": 405.11
            },
            {
              "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": 641,
              "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": 525.62
            },
            {
              "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": 174.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.85
            },
            {
              "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": 411.52
            },
            {
              "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": 411.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.29
            },
            {
              "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": 355.76
            },
            {
              "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": 33.58,
              "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": 544.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 641,
              "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": 417.29
            },
            {
              "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": 34.56,
              "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": 480.75
            },
            {
              "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": 32.91,
              "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": 467.93
            },
            {
              "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": 33.58,
              "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": 544.85
            },
            {
              "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": 544.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.11
            }
          ]
        }
      ]
    },
    {
      "description": "HC Egd W Drainage Pseudocyst",
      "code_information": [
        {
          "code": "PX-75000016",
          "type": "CDM"
        },
        {
          "code": "43240",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7809,
          "discounted_cash": 5075.85,
          "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": 5013.38
            },
            {
              "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": 5075.85
            },
            {
              "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": 4935.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 2131.86
            },
            {
              "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": 6403.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7809,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6473.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5700.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5169.56
            },
            {
              "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": 5013.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4935.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5013.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6317.48
            },
            {
              "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": 7809,
              "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": 6637.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4935.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7809,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5700.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5083.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4935.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 4294.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4294.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5856.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6473.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5013.38
            },
            {
              "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": 6403.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "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": 1710.17
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5700.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7809,
              "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": 5700.57
            },
            {
              "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": 5083.66
            },
            {
              "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": 6317.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6403.38
            },
            {
              "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": 6403.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4294.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "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": 4935.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 5013.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5013.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 5700.57
            },
            {
              "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": 6637.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4935.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4294.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5700.57
            },
            {
              "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": 7809,
              "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": 7809,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7809,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5856.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5083.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5169.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 6871.92
            },
            {
              "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": 6637.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4294.95
            },
            {
              "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": 5013.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 4935.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4935.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5169.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6403.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4294.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7809,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5169.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6403.38
            },
            {
              "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": 5013.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5856.75
            },
            {
              "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": 6473.66
            },
            {
              "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": 6848.49
            },
            {
              "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": 6848.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 7809,
              "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": 5013.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5083.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4294.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4989.95
            },
            {
              "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": 5013.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5013.38
            },
            {
              "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": 5083.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6637.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5013.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6403.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6403.38
            },
            {
              "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": 7809,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Egd W Sclerotherapy",
      "code_information": [
        {
          "code": "PX-75000019",
          "type": "CDM"
        },
        {
          "code": "43243",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5132,
          "discounted_cash": 3335.8,
          "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": 3294.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5132,
              "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": 4500.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3340.93
            },
            {
              "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": 4362.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "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": 3294.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4254.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5132,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3340.93
            },
            {
              "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": 4208.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3294.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3340.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3294.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3397.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2822.6
            },
            {
              "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": 5132,
              "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": 4500.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3746.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3746.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "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": 3340.93
            },
            {
              "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": 3294.74
            },
            {
              "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": 4151.79
            },
            {
              "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": 4208.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "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": 3243.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2822.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "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": 4516.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2822.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4208.24
            },
            {
              "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": 4362.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3294.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5132,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2822.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3746.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3243.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3243.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "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": 3294.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3294.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "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": 1401.04
            },
            {
              "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": 3746.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3340.93
            },
            {
              "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": 4208.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3294.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3746.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "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": 1123.91
            },
            {
              "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": 3335.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5132,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2822.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3746.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5132,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5132,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4208.24
            },
            {
              "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": 4254.43
            },
            {
              "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": 5132,
              "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": 2822.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3243.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3243.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4208.24
            },
            {
              "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": 3294.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4208.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3849
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3243.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4208.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2822.6
            },
            {
              "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": 5132,
              "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": 4151.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4362.2
            },
            {
              "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": 3243.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3397.38
            },
            {
              "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": 5132,
              "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": 4362.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3849
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3397.38
            },
            {
              "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": 3294.74
            },
            {
              "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": 3243.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3279.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3397.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3294.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3849
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4254.43
            }
          ]
        }
      ]
    },
    {
      "description": "HC Egd W Peg Placement",
      "code_information": [
        {
          "code": "PX-75000022",
          "type": "CDM"
        },
        {
          "code": "43246",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4489,
          "discounted_cash": 2917.85,
          "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": 2881.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2922.34
            },
            {
              "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": 3276.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2971.72
            },
            {
              "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": 4489,
              "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": 4489,
              "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": 2881.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2881.94
            },
            {
              "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": 3680.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2468.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3631.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4489,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4489,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2468.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2468.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "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": 2881.94
            },
            {
              "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": 3680.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2837.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3276.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2468.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3276.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3721.38
            },
            {
              "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": 2881.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "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": 3936.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2837.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2971.72
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2881.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3366.75
            },
            {
              "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": 983.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3680.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2881.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4489,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4489,
              "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": 2468.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3276.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3276.97
            },
            {
              "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": 4489,
              "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": 2837.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2837.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2971.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3680.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2881.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3366.75
            },
            {
              "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": 3815.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2881.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2922.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3680.98
            },
            {
              "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": 3680.98
            },
            {
              "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": 2837.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2971.72
            },
            {
              "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": 3721.38
            },
            {
              "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": 2922.34
            },
            {
              "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": 3631.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2922.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3366.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4489,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2881.94
            },
            {
              "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": 2837.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "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": 3950.32
            },
            {
              "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": 2837.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "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": 2922.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3680.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "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": 2881.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3276.97
            },
            {
              "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": 4489,
              "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": 3721.38
            },
            {
              "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": 1225.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4489,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2837.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "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": 2917.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "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": 2468.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2868.47
            },
            {
              "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": 3936.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3815.65
            },
            {
              "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": 2881.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3680.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2468.95
            }
          ]
        }
      ]
    },
    {
      "description": "HC Egd W/Stent/Dilation/Guidewire",
      "code_information": [
        {
          "code": "PX-75000029",
          "type": "CDM"
        },
        {
          "code": "43266",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5346,
          "discounted_cash": 3474.9,
          "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": 3432.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4324.91
            },
            {
              "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": 4383.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4009.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3432.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5346,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3902.58
            },
            {
              "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": 3432.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2940.3
            },
            {
              "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": 3902.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3432.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3902.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "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": 3432.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "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": 5346,
              "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": 4324.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3902.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "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": 4704.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2940.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4383.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2940.3
            },
            {
              "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": 4431.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3378.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "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": 3474.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3432.13
            },
            {
              "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": 3432.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4383.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4383.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "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": 4688.44
            },
            {
              "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": 1170.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2940.3
            },
            {
              "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": 4544.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3432.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3432.13
            },
            {
              "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": 4383.72
            },
            {
              "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": 1459.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5346,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3378.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5346,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3539.05
            },
            {
              "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": 3432.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3378.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2940.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3378.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4009.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4383.72
            },
            {
              "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": 4544.1
            },
            {
              "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": 5346,
              "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": 3378.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3539.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "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": 3432.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5346,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2940.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4383.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3480.25
            },
            {
              "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": 3378.67
            },
            {
              "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": 5346,
              "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": 3902.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3902.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3539.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5346,
              "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": 4688.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3480.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4009.5
            },
            {
              "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": 3480.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3378.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3378.67
            },
            {
              "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": 2940.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4431.83
            },
            {
              "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": 4383.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5346,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5346,
              "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": 3480.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3432.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3539.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4431.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4544.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3416.09
            },
            {
              "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": 3480.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ercp",
      "code_information": [
        {
          "code": "PX-75000032",
          "type": "CDM"
        },
        {
          "code": "43260",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10042,
          "discounted_cash": 6527.3,
          "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": 6446.96
            },
            {
              "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": 6446.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5523.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7330.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "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": 10042,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8234.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "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": 8234.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8234.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6647.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10042,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5523.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6346.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "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": 6346.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6446.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7330.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10042,
              "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": 8234.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5523.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8123.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8234.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10042,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "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": 8836.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7531.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6537.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6346.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "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": 7330.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8324.82
            },
            {
              "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": 6537.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6537.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6446.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7531.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10042,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8324.82
            },
            {
              "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": 2199.2
            },
            {
              "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": 10042,
              "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": 5523.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10042,
              "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": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "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": 10042,
              "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": 6537.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8234.44
            },
            {
              "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": 2741.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5523.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7330.66
            },
            {
              "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": 8535.7
            },
            {
              "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": 8806.83
            },
            {
              "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": 6346.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6647.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7531.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6346.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5523.1
            },
            {
              "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": 8123.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8234.44
            },
            {
              "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": 8806.83
            },
            {
              "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": 6446.96
            },
            {
              "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": 6537.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6346.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10042,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10042,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6346.54
            },
            {
              "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": 8535.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6446.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7330.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8535.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7330.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6446.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6647.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5523.1
            },
            {
              "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": 6346.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "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": 6527.3
            },
            {
              "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": 8324.82
            },
            {
              "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": 6446.96
            },
            {
              "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": 8234.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6416.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6647.8
            },
            {
              "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": 6446.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6446.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6446.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6446.96
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sigmoidoscopy",
      "code_information": [
        {
          "code": "PX-75000082",
          "type": "CDM"
        },
        {
          "code": "45330",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4382,
          "discounted_cash": 2848.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2813.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "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": 3856.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3545.04
            },
            {
              "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": 1196.29
            },
            {
              "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": 2769.42
            },
            {
              "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": 2848.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4382,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4382,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3198.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2813.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3593.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3286.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4382,
              "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": 3593.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4382,
              "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": 3724.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2813.24
            },
            {
              "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": 2852.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2900.88
            },
            {
              "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": 4382,
              "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": 2769.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2900.88
            },
            {
              "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": 3843.01
            },
            {
              "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": 3843.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2813.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2813.24
            },
            {
              "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": 3632.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3632.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2769.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2769.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3198.86
            },
            {
              "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": 2769.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4382,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2410.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4382,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2410.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "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": 3593.24
            },
            {
              "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": 3593.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2769.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2900.88
            },
            {
              "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": 2410.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "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": 4382,
              "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": 2410.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2852.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2852.68
            },
            {
              "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": 3593.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2410.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "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": 3724.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "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": 3198.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2852.68
            },
            {
              "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": 2852.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2769.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3593.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3593.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3593.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "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": 959.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2410.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4382,
              "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": 2813.24
            },
            {
              "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": 3545.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3286.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2900.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3198.86
            },
            {
              "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": 2813.24
            },
            {
              "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": 2813.24
            },
            {
              "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": 2813.24
            },
            {
              "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": 2813.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3632.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2410.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3198.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2769.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3198.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2813.24
            },
            {
              "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": 4382,
              "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": 63.9,
              "estimated_amount": 2800.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3286.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            },
            {
              "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": 2813.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3724.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sigmoidoscopy W Removal FB",
      "code_information": [
        {
          "code": "PX-75000084",
          "type": "CDM"
        },
        {
          "code": "45332",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4955,
          "discounted_cash": 3220.75,
          "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": 3181.11
            },
            {
              "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": 3181.11
            },
            {
              "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": 3220.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4107.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3716.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "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": 3181.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4955,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3617.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3617.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3181.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3225.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2725.25
            },
            {
              "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": 2725.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3716.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "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": 4360.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2725.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3181.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3181.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3617.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4955,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4107.7
            },
            {
              "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": 3131.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3131.56
            },
            {
              "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": 4063.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2725.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4955,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "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": 4955,
              "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": 4345.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3131.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3280.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3225.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4063.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4955,
              "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": 4211.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3131.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2725.25
            },
            {
              "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": 1352.72
            },
            {
              "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": 3225.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3617.15
            },
            {
              "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": 3131.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3131.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3280.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "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": 4955,
              "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": 4063.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4063.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4955,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3131.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3181.11
            },
            {
              "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": 4008.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3617.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3617.15
            },
            {
              "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": 3181.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3716.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3280.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3225.71
            },
            {
              "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": 3225.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "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": 4211.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "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": 4345.54
            },
            {
              "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": 4063.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4955,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3131.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3280.21
            },
            {
              "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": 1085.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4063.1
            },
            {
              "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": 3181.11
            },
            {
              "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": 4211.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2725.25
            },
            {
              "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": 4955,
              "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": 3181.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4008.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2725.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "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": 4107.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3166.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3181.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4063.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4211.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4955,
              "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": 3181.11
            },
            {
              "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": 4063.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Anorectal Manometry Test",
      "code_information": [
        {
          "code": "PX-75000123",
          "type": "CDM"
        },
        {
          "code": "91122",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2747,
          "discounted_cash": 1785.55,
          "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": 1763.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2277.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2747,
              "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": 2060.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1763.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1510.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1510.85
            },
            {
              "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": 2252.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2060.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2747,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1788.3
            },
            {
              "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": 749.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1818.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2747,
              "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": 1736.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2005.31
            },
            {
              "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": 2334.95
            },
            {
              "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": 1763.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2252.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2747,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1510.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1788.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1736.1
            },
            {
              "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": 2277.26
            },
            {
              "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": 2005.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "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": 1763.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2277.26
            },
            {
              "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": 1763.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2222.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1763.57
            },
            {
              "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": 1788.3
            },
            {
              "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": 2334.95
            },
            {
              "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": 2747,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2747,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "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": 1788.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2252.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "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": 2409.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1763.57
            },
            {
              "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": 2222.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2252.54
            },
            {
              "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": 2417.36
            },
            {
              "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": 601.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1510.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2005.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1763.57
            },
            {
              "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": 2747,
              "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": 2334.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1818.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2005.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2005.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1736.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1736.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "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": 1510.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2252.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1510.85
            },
            {
              "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": 1736.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "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": 1763.57
            },
            {
              "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": 2409.12
            },
            {
              "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": 2747,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1755.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1818.51
            },
            {
              "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": 1736.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1736.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1763.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2747,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1510.85
            },
            {
              "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": 1763.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2252.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2005.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1818.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2747,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "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": 1785.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1763.57
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2060.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2334.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1788.3
            },
            {
              "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": 2252.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2252.54
            },
            {
              "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": 1736.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cephalic Version",
      "code_information": [
        {
          "code": "PX-76100001",
          "type": "CDM"
        },
        {
          "code": "59412",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4435,
          "discounted_cash": 2882.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2847.27
            },
            {
              "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": 2670.97,
              "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": 4435,
              "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": 4435,
              "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": 2847.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2887.19
            },
            {
              "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": 2461.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3769.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2439.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3769.75
            },
            {
              "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": 2755.93,
              "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": 4435,
              "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": 3769.75
            },
            {
              "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": 2461.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 4435,
              "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": 2725.48,
              "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": 4435,
              "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": 4435,
              "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": 2755.93,
              "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": 4435
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2847.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3636.7
            },
            {
              "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": 3636.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 4435,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3636.7
            },
            {
              "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": 3889.5
            },
            {
              "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": 3769.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3237.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2755.93,
              "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": 2670.97,
              "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": 2847.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3676.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 2725.48,
              "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": 3769.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3769.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2439.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3237.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3769.75
            },
            {
              "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": 2461.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2439.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 3769.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2802.92
            },
            {
              "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": 3676.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 2439.25
            },
            {
              "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": 3587.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2847.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3636.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3326.25
            },
            {
              "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": 1210.76
            },
            {
              "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": 2670.97,
              "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": 2847.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2461.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3237.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2802.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 3769.75
            },
            {
              "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": 3902.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3237.55
            },
            {
              "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": 4435,
              "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": 2887.19
            },
            {
              "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": 2865.07,
              "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": 4435,
              "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": 3769.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3769.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3326.25
            },
            {
              "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": 2847.27
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 423
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2439.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 4435,
              "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": 3889.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2802.92
            },
            {
              "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": 4435,
              "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": 2847.27
            },
            {
              "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": 2755.93,
              "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": 2847.27
            },
            {
              "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": 2887.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3769.75
            },
            {
              "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": 2802.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3769.75
            },
            {
              "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": 3769.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2847.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2847.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3326.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2802.92
            },
            {
              "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": 2802.92
            },
            {
              "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": 2804.52,
              "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": 3676.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4435,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "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": 4435,
              "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": 3237.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2887.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3636.7
            },
            {
              "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": 2887.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 3237.55
            },
            {
              "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": 2670.97,
              "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": 2865.07,
              "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": 3636.7
            },
            {
              "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": 2439.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2439.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2802.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4435,
              "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": 2882.75
            },
            {
              "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": 3636.7
            },
            {
              "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": 2755.93,
              "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": 2847.27
            },
            {
              "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": 2725.48,
              "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": 3636.7
            },
            {
              "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": 2802.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3587.92
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hemodialysis Proc IP 1 Eval",
      "code_information": [
        {
          "code": "PX-80100001",
          "type": "CDM"
        },
        {
          "code": "90935",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5490,
          "discounted_cash": 3568.5,
          "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": 3524.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4007.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 1202.31
            },
            {
              "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": 3046.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4551.21
            },
            {
              "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": 3573.99
            },
            {
              "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": 3019.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4501.8
            },
            {
              "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": 609.19,
              "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": 609.19,
              "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": 4501.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4666.5
            },
            {
              "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": 3524.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4501.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4666.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5490
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3524.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 3019.5
            },
            {
              "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": 616,
              "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": 4501.8
            },
            {
              "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": 4831.2
            },
            {
              "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": 616,
              "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": 3524.58
            },
            {
              "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": 597.01,
              "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": 640.4,
              "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": 3019.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4007.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 640.4,
              "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": 5490,
              "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": 3524.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4501.8
            },
            {
              "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": 5490,
              "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": 3524.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 4666.5
            },
            {
              "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": 3524.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3524.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4441.41
            },
            {
              "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": 616,
              "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": 4666.5
            },
            {
              "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": 5490,
              "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": 616,
              "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": 609.19,
              "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": 3524.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4117.5
            },
            {
              "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": 1498.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3019.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3019.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3469.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 4666.5
            },
            {
              "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": 3046.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 3573.99
            },
            {
              "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": 4814.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 5490,
              "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": 5490,
              "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": 4007.7
            },
            {
              "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": 3573.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4666.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 4666.5
            },
            {
              "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": 4501.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4666.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4117.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4007.7
            },
            {
              "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": 3524.58
            },
            {
              "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": 3469.68
            },
            {
              "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": 4007.7
            },
            {
              "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": 5490,
              "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": 3469.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3469.68
            },
            {
              "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": 4814.73
            },
            {
              "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": 4551.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5490,
              "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": 3469.68
            },
            {
              "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": 3469.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 5490,
              "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": 5490,
              "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": 5490,
              "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": 5490,
              "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": 5490,
              "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": 597.01,
              "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": 4666.5
            },
            {
              "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": 3524.58
            },
            {
              "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": 616,
              "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": 4117.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3469.68
            },
            {
              "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": 4441.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4666.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3019.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4666.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4501.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3573.99
            },
            {
              "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": 597.01,
              "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": 3046.95
            },
            {
              "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": 4666.5
            },
            {
              "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": 597.01,
              "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": 4666.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3019.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4666.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3469.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4551.21
            },
            {
              "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": 4501.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4007.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3524.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3573.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5490,
              "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": 3568.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3046.95
            },
            {
              "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": 626.86,
              "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": 5490,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Therap Tms Treatment Intial",
      "code_information": [
        {
          "code": "PX-90000004",
          "type": "CDM"
        },
        {
          "code": "90867",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 863,
          "discounted_cash": 560.95,
          "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": 64.2,
              "estimated_amount": 554.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 561.81
            },
            {
              "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": 273.95,
              "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": 629.99
            },
            {
              "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": 276.69,
              "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": 733.55
            },
            {
              "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": 560.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 474.65
            },
            {
              "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": 273.95,
              "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": 545.42
            },
            {
              "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": 756.85
            },
            {
              "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": 279.54,
              "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": 715.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 629.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 545.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 863,
              "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": 698.17
            },
            {
              "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": 235.6
            },
            {
              "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": 545.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 733.55
            },
            {
              "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": 276.69,
              "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": 863,
              "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": 554.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 545.42
            },
            {
              "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": 287.65,
              "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": 733.55
            },
            {
              "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": 474.65
            },
            {
              "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": 276.69,
              "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": 478.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 733.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 707.66
            },
            {
              "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": 273.95,
              "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": 554.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 545.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 756.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 733.55
            },
            {
              "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": 276.69,
              "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": 554.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 629.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 478.97
            },
            {
              "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": 733.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 647.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 554.05
            },
            {
              "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": 561.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 707.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 707.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 474.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 474.65
            },
            {
              "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": 287.65,
              "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": 733.55
            },
            {
              "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": 759.44
            },
            {
              "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": 863,
              "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": 863,
              "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": 629.99
            },
            {
              "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": 629.99
            },
            {
              "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": 698.17
            },
            {
              "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": 707.66
            },
            {
              "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": 287.65,
              "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": 478.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 863,
              "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": 863,
              "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": 707.66
            },
            {
              "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": 561.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 863,
              "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": 478.97
            },
            {
              "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": 707.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 561.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 707.66
            },
            {
              "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": 545.42
            },
            {
              "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": 554.05
            },
            {
              "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": 554.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 629.99
            },
            {
              "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": 863,
              "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": 647.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 561.81
            },
            {
              "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": 863,
              "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": 733.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 715.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.69,
              "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": 733.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 545.42
            },
            {
              "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": 279.54,
              "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": 733.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 554.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 554.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 733.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 863,
              "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": 545.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 554.05
            },
            {
              "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": 554.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 707.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 474.65
            },
            {
              "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": 273.95,
              "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": 863,
              "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": 733.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 733.55
            },
            {
              "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": 715.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 474.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 863,
              "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": 863
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 474.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 554.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 863,
              "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": 863,
              "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": 279.54,
              "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": 647.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 733.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC Duplex Scan Penile Vessels Complete",
      "code_information": [
        {
          "code": "PX-92100021",
          "type": "CDM"
        },
        {
          "code": "93980",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1349,
          "discounted_cash": 876.85,
          "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": 866.06
            },
            {
              "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": 1106.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 984.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 1011.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1349,
              "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": 1146.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 866.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 741.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 866.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1106.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 1349,
              "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": 748.7
            },
            {
              "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": 1183.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 866.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 866.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 1349,
              "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": 1349,
              "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": 1349,
              "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": 984.77
            },
            {
              "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": 1146.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "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": 748.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 984.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 852.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 866.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 741.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 1187.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 748.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "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": 1106.18
            },
            {
              "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": 878.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1349
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 741.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "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": 852.57
            },
            {
              "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": 866.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 1349,
              "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": 1349,
              "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": 1118.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 741.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 1349,
              "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": 1146.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1091.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 741.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 852.57
            },
            {
              "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": 1118.32
            },
            {
              "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": 748.7
            },
            {
              "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": 866.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 878.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1106.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 984.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 852.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1106.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1011.75
            },
            {
              "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": 866.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1106.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1106.18
            },
            {
              "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": 876.85
            },
            {
              "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": 741.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 984.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 852.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 1349,
              "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": 1011.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 878.2
            },
            {
              "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": 1106.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 866.06
            },
            {
              "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": 852.57
            },
            {
              "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": 852.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "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": 1349,
              "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": 1349,
              "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": 878.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1118.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 852.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1146.65
            },
            {
              "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": 878.2
            },
            {
              "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": 368.28
            },
            {
              "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": 1146.65
            },
            {
              "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": 1183.07
            },
            {
              "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": 1349,
              "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": 1349,
              "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": 741.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 984.77
            },
            {
              "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": 866.06
            },
            {
              "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": 1091.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1349,
              "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": 866.06
            }
          ]
        }
      ]
    },
    {
      "description": "HC Med Weight Tx Screening Lc",
      "code_information": [
        {
          "code": "PX-94200006",
          "type": "CDM"
        },
        {
          "code": "S9449",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 336,
          "discounted_cash": 218.4,
          "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": 215.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 215.71
            },
            {
              "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": 275.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 184.8
            },
            {
              "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": 212.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 285.6
            },
            {
              "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": 336,
              "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": 215.71
            },
            {
              "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": 275.52
            },
            {
              "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": 278.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 218.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 215.71
            },
            {
              "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": 215.71
            },
            {
              "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": 212.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 252
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 245.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 275.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 275.52
            },
            {
              "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": 336,
              "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": 285.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 245.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 215.71
            },
            {
              "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": 271.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 275.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 186.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 278.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 212.35
            },
            {
              "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": 294.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 212.35
            },
            {
              "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": 294.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 336,
              "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": 336,
              "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": 215.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 218.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 275.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 252
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 285.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 212.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 184.8
            },
            {
              "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": 186.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 215.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 215.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 184.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 218.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 275.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 212.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 336
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 245.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 245.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "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": 285.6
            },
            {
              "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": 336,
              "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": 336,
              "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": 184.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 218.4
            },
            {
              "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": 336,
              "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": 186.48
            },
            {
              "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": 336,
              "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": 295.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 245.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 252
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 215.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 218.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 336,
              "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": 91.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "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": 184.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 278.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 336,
              "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": 336,
              "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": 285.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "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": 336,
              "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": 184.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 285.6
            },
            {
              "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": 215.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 186.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 245.28
            },
            {
              "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": 275.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 184.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 215.71
            },
            {
              "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": 218.74
            },
            {
              "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": 336,
              "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": 212.35
            },
            {
              "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": 212.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 336,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Med Wt Screen Promotion",
      "code_information": [
        {
          "code": "PX-94200008",
          "type": "CDM"
        },
        {
          "code": "S9449",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 171,
          "discounted_cash": 111.15,
          "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": 109.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 108.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 109.78
            },
            {
              "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": 94.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 141.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "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": 145.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 109.78
            },
            {
              "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": 171,
              "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": 171,
              "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": 171,
              "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": 171,
              "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": 145.35
            },
            {
              "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": 111.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 124.83
            },
            {
              "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": 149.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 128.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "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": 140.22
            },
            {
              "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": 109.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 108.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 171,
              "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": 145.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 109.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "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": 108.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 109.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 145.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 145.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 94.05
            },
            {
              "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": 138.34
            },
            {
              "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": 140.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 128.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 138.34
            },
            {
              "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": 141.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 109.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 171,
              "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": 109.78
            },
            {
              "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": 109.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 108.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 108.07
            },
            {
              "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": 109.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "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": 46.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 128.25
            },
            {
              "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": 171,
              "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": 111.32
            },
            {
              "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": 140.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 145.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 124.83
            },
            {
              "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": 171,
              "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": 171,
              "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": 109.78
            },
            {
              "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": 111.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 111.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 108.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 124.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 171
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 94.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 141.76
            },
            {
              "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": 108.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 150.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 124.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 94.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "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": 108.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 124.83
            },
            {
              "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": 124.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 109.78
            },
            {
              "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": 149.97
            },
            {
              "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": 171,
              "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": 111.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "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": 94.91
            },
            {
              "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": 145.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 171,
              "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": 171,
              "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": 94.05
            },
            {
              "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": 111.32
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ide G150101 Control Htn Rox Coupler",
      "code_information": [
        {
          "code": "PX-62400191",
          "type": "CDM"
        },
        {
          "code": "C1889",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1,
          "discounted_cash": 0.65,
          "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": 0.64
            },
            {
              "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": 1,
              "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": 1,
              "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": 1,
              "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": 0.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.81
            },
            {
              "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": 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": 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,
              "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,
              "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,
              "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": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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,
              "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,
              "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": 0.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.63
            },
            {
              "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": 1,
              "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,
              "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": 0.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 0.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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,
              "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,
              "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": 0.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.73
            },
            {
              "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": 0.64
            },
            {
              "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": 0.65
            },
            {
              "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": 0.81
            },
            {
              "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": 1,
              "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": 0.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.83
            },
            {
              "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": 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": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "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": 1,
              "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": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 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": 1,
              "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": 0.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "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": 1,
              "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": 1,
              "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,
              "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": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.65
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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,
              "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": 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": 0.85
            },
            {
              "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": 1,
              "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": 0.64
            },
            {
              "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": 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": 1,
              "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": 0.55
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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,
              "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,
              "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": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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": 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": 0.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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,
              "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": 0.85
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 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": 0.88
            },
            {
              "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": 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": 0.82
            },
            {
              "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": 1,
              "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": 1,
              "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": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "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": 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": 1,
              "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": 0.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Grafix Prime 5 X 5 per Sq Cm",
      "code_information": [
        {
          "code": "PX-63600048",
          "type": "CDM"
        },
        {
          "code": "Q4133",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 350,
          "discounted_cash": 227.5,
          "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": 224.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 350
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 283.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 350,
              "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": 221.2
            },
            {
              "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": 350,
              "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": 297.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 262.5
            },
            {
              "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": 306.95
            },
            {
              "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": 255.5
            },
            {
              "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": 350,
              "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": 95.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 290.15
            },
            {
              "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": 350,
              "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": 224.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 297.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 221.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 350,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 350,
              "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": 227.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 350,
              "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": 262.5
            },
            {
              "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": 350,
              "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": 221.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 221.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "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": 350,
              "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": 224.7
            },
            {
              "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": 224.7
            },
            {
              "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": 227.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 224.7
            },
            {
              "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": 350,
              "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": 287
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 350,
              "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": 350,
              "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": 297.5
            },
            {
              "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": 350,
              "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": 221.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 224.7
            },
            {
              "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": 194.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 350,
              "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": 297.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 350,
              "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": 290.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 350,
              "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": 297.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 350,
              "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": 350,
              "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": 297.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 287
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "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": 350,
              "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": 194.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 297.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 262.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "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": 350,
              "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": 221.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.7
            },
            {
              "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": 306.95
            },
            {
              "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": 350,
              "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": 194.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 221.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 287
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 290.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 227.85
            },
            {
              "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": 194.25
            },
            {
              "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": 227.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 227.85
            },
            {
              "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": 350,
              "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": 297.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 350,
              "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": 192.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "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": 308
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 221.2
            },
            {
              "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": 287
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "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": 350,
              "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": 297.5
            },
            {
              "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": 224.7
            },
            {
              "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": 227.85
            },
            {
              "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": 287
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 350,
              "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": 283.15
            },
            {
              "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": 350,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ot Paraffin Bath",
      "code_information": [
        {
          "code": "PX-43000015",
          "type": "CDM"
        },
        {
          "code": "97018",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 107,
          "discounted_cash": 69.55,
          "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": 68.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.85
            },
            {
              "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": 67.62
            },
            {
              "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": 67.62
            },
            {
              "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": 93.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 69.66
            },
            {
              "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": 86.56
            },
            {
              "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": 90.95
            },
            {
              "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": 107,
              "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": 68.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.62
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.62
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 90.95
            },
            {
              "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": 68.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.62
            },
            {
              "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": 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": 87.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 107,
              "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": 90.95
            },
            {
              "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": 107,
              "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": 58.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.11
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.74
            },
            {
              "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": 88.7
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107,
              "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": 107,
              "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": 68.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.66
            },
            {
              "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": 5.37
            },
            {
              "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": 10.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 90.95
            },
            {
              "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": 107,
              "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": 94.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.85
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.66
            },
            {
              "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": 78.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 5.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 86.56
            },
            {
              "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": 90.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 58.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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,
              "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": 107,
              "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": 90.95
            },
            {
              "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": 68.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.69
            },
            {
              "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": 59.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.66
            },
            {
              "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": 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": 80.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.95
            },
            {
              "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": 5.37
            },
            {
              "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": 93.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 107
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.69
            },
            {
              "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": 29.21
            },
            {
              "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,
              "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": 90.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.85
            },
            {
              "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": 67.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.25
            },
            {
              "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": 59.39
            },
            {
              "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": 58.85
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.74
            },
            {
              "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": 87.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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,
              "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": 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": 78.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 90.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 107,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.7
            },
            {
              "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": 87.74
            },
            {
              "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": 5.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.11
            },
            {
              "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": 68.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107,
              "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": 90.95
            },
            {
              "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": 69.66
            },
            {
              "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": 87.74
            }
          ]
        }
      ]
    },
    {
      "description": "HC Introducer Single Lumen",
      "code_information": [
        {
          "code": "PX-27200367",
          "type": "CDM"
        },
        {
          "code": "27200367",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 258,
          "discounted_cash": 167.7,
          "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": 165.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 165.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "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": 143.19
            },
            {
              "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": 226.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 167.44
            },
            {
              "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": 211.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 141.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 167.96
            },
            {
              "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": 70.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 258
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 211.56
            },
            {
              "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": 163.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 141.9
            },
            {
              "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": 219.3
            },
            {
              "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": 165.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "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": 258,
              "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": 188.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 211.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 167.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 258,
              "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": 193.5
            },
            {
              "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": 258,
              "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": 167.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 165.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 167.44
            },
            {
              "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": 167.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 213.88
            },
            {
              "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": 219.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "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": 188.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "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": 211.56
            },
            {
              "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": 162.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 188.34
            },
            {
              "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": 258,
              "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": 162.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 141.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 165.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 165.64
            },
            {
              "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": 165.64
            },
            {
              "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": 143.19
            },
            {
              "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": 226.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 193.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 213.88
            },
            {
              "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": 162.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 167.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "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": 258,
              "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": 165.64
            },
            {
              "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": 165.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 165.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.06
            },
            {
              "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": 143.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.06
            },
            {
              "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": 163.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 211.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 141.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 141.9
            },
            {
              "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": 167.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "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": 211.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 143.19
            },
            {
              "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": 227.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 165.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 211.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 193.5
            },
            {
              "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": 208.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 211.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.06
            },
            {
              "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": 167.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 167.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 141.9
            },
            {
              "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": 141.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 188.34
            },
            {
              "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": 165.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 208.72
            },
            {
              "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": 163.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.02
            },
            {
              "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": 213.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 219.3
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ot Tx Cot 15 Min",
      "code_information": [
        {
          "code": "PX-43000059",
          "type": "CDM"
        },
        {
          "code": "43000059",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21,
          "discounted_cash": 13.65,
          "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": 13.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.33
            },
            {
              "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": 18.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.41
            },
            {
              "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": 13.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "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": 15.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21,
              "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": 21,
              "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": 13.19
            },
            {
              "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": 13.48
            },
            {
              "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": 13.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 17.85
            },
            {
              "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": 13.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 13.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "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": 18.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.33
            },
            {
              "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": 11.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "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": 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": 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": 11.66
            },
            {
              "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": 16.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "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": 17.22
            },
            {
              "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": 5.73
            },
            {
              "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": 21,
              "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": 15.33
            },
            {
              "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": 11.66
            },
            {
              "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": 17.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 17.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "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": 13.48
            },
            {
              "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": 18.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "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": 16.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "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": 13.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 17.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.63
            },
            {
              "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": 17.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "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": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.63
            },
            {
              "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": 17.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.63
            },
            {
              "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": 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": 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": 21,
              "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": 15.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.75
            },
            {
              "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": 13.27
            },
            {
              "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": 13.27
            },
            {
              "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": 21,
              "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": 13.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.75
            },
            {
              "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": 13.48
            },
            {
              "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": 13.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "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": 11.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC Heart Valve 8",
      "code_information": [
        {
          "code": "PX-27800154",
          "type": "CDM"
        },
        {
          "code": "27800154",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5804,
          "discounted_cash": 3772.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3801.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3708.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3708.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4236.92
            },
            {
              "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": 3801.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3221.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3708.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "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": 4695.44
            },
            {
              "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": 3540.44
            },
            {
              "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": 3221.22
            },
            {
              "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": 4933.4
            },
            {
              "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": 3192.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3778.4
            },
            {
              "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": 3720.36
            },
            {
              "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": 3778.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "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": 4759.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3801.62
            },
            {
              "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": 3801.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.2
            },
            {
              "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": 4933.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3708.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "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": 5804,
              "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": 3540.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "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": 4759.28
            },
            {
              "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": 5090.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4236.92
            },
            {
              "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": 3221.22
            },
            {
              "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": 5804,
              "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": 1584.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "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": 5090.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4759.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "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": 5107.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4236.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4236.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4759.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3801.62
            },
            {
              "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": 4811.52
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "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": 3778.4
            },
            {
              "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": 3772.6
            },
            {
              "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": 5804,
              "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": 3801.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3801.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3778.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4695.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4811.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5804
            },
            {
              "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": 3801.62
            },
            {
              "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": 4236.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3778.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4759.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4933.4
            },
            {
              "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": 5804,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4236.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4759.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4353
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "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": 3221.22
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5804,
              "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": 4759.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4353
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4353
            },
            {
              "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": 3720.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3540.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4811.52
            },
            {
              "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": 3720.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3720.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4759.28
            }
          ]
        }
      ]
    },
    {
      "description": "HC Genotype Dna or Rna Hiv So",
      "code_information": [
        {
          "code": "PX-30600278",
          "type": "CDM"
        },
        {
          "code": "87906",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1328,
          "discounted_cash": 863.2,
          "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": 852.58
            },
            {
              "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": 864.53
            },
            {
              "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": 730.4
            },
            {
              "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": 1164.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 839.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 737.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "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": 852.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1100.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1088.96
            },
            {
              "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": 839.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1088.96
            },
            {
              "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": 839.3
            },
            {
              "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": 969.44
            },
            {
              "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": 737.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 864.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 969.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 852.58
            },
            {
              "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": 864.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 852.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1088.96
            },
            {
              "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": 1100.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 730.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 730.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 852.58
            },
            {
              "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": 1088.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1100.91
            },
            {
              "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": 852.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 852.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 864.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 864.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 839.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "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": 1168.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1088.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 996
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 730.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1328
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 730.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "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": 362.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 996
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 839.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 996
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 969.44
            },
            {
              "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": 852.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "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": 852.58
            },
            {
              "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": 1328,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 183.22,
              "estimated_amount": 183.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 852.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1088.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "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": 737.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 839.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "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": 1328,
              "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": 852.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "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": 863.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1074.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "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": 839.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 730.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 730.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 969.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "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": 1328,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 183.22,
              "estimated_amount": 183.22
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 969.44
            },
            {
              "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": 1164.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 839.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "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": 1074.35
            },
            {
              "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": 1088.96
            },
            {
              "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": 737.04
            },
            {
              "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": 1128.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 969.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 852.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            },
            {
              "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": 1088.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1128.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 482.74,
              "estimated_amount": 482.74
            }
          ],
          "minimum": 183.22,
          "maximum": 482.74
        }
      ]
    },
    {
      "description": "HC Low Cost Appl Sg Trnk Arms Legs 100 Cm; Ea Add 25 Cm",
      "code_information": [
        {
          "code": "PX-51000081",
          "type": "CDM"
        },
        {
          "code": "C5272",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1006,
          "discounted_cash": 653.9,
          "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": 645.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 734.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 734.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 855.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1006
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 734.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 813.85
            },
            {
              "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": 824.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 654.91
            },
            {
              "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": 813.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.85
            },
            {
              "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": 553.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 855.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 754.5
            },
            {
              "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": 1006,
              "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": 1006,
              "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": 635.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 553.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 558.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 734.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 855.1
            },
            {
              "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": 645.85
            },
            {
              "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": 654.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 855.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 855.1
            },
            {
              "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": 833.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 553.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.85
            },
            {
              "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": 1006,
              "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": 824.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 855.1
            },
            {
              "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": 1006,
              "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": 645.85
            },
            {
              "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": 855.1
            },
            {
              "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": 635.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 734.38
            },
            {
              "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": 855.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.79
            },
            {
              "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": 882.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 855.1
            },
            {
              "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": 274.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 553.3
            },
            {
              "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": 1006,
              "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": 1006,
              "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": 1006,
              "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": 882.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 553.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 553.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 833.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 855.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 558.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 833.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 734.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 635.79
            },
            {
              "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": 635.79
            },
            {
              "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": 653.9
            },
            {
              "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": 645.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 855.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 824.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 645.85
            },
            {
              "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": 654.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 553.3
            },
            {
              "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": 645.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 885.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 654.91
            },
            {
              "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": 824.92
            },
            {
              "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": 558.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.79
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 855.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1006,
              "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": 1006,
              "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": 558.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 654.91
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Derma Dry Bariatric 3xlg 70in-94in Attends",
      "code_information": [
        {
          "code": "PX-CH-IMCDD60",
          "type": "CDM"
        },
        {
          "code": "T4524",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.75,
          "discounted_cash": 3.09,
          "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": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.56
            },
            {
              "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": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "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": 2.64
            },
            {
              "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": 4.75,
              "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": 4.75,
              "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": 2.61
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 3.56
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 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": 4.04
            },
            {
              "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": 4.75,
              "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": 4.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "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": 3.9
            },
            {
              "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": 4.75,
              "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": 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": 3.47
            },
            {
              "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": 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": "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": "HUMANA [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": "AETNA [310]",
              "plan_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 HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 4.75,
              "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": 4.75,
              "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": 4.75,
              "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": 4.75,
              "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": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.75,
              "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": 4.04
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 4.75,
              "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": 4.04
            },
            {
              "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": 2.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.56
            },
            {
              "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": 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": 3.05
            },
            {
              "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": 3.09
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.09
            },
            {
              "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": 1.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "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": 4.75,
              "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": 3.84
            },
            {
              "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": "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "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": 2.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 3.94
            },
            {
              "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 OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 4.75,
              "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": 3.05
            },
            {
              "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": "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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 2.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 2.61
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "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": 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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 4.75,
              "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": 4.75,
              "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": 2.64
            },
            {
              "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": 3.9
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.75,
              "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": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            }
          ]
        }
      ]
    },
    {
      "description": "Irrigation Tray W/60cc Bulb Syringe",
      "code_information": [
        {
          "code": "PX-CH-SH471334",
          "type": "CDM"
        },
        {
          "code": "A4320",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.09,
          "discounted_cash": 1.36,
          "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": 1.34
            },
            {
              "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": 2.09,
              "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": 1.16
            },
            {
              "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": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.69
            },
            {
              "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": 2.09,
              "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": 2.09,
              "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": 1.32
            },
            {
              "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": 1.34
            },
            {
              "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": 1.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 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": 1.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.71
            },
            {
              "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": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 2.09,
              "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": 2.09,
              "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": 2.09,
              "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": 2.09,
              "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": 2.09,
              "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": 1.57
            },
            {
              "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": 2.09,
              "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": 2.09,
              "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": 1.73
            },
            {
              "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": 1.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 2.09,
              "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": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.16
            },
            {
              "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": 1.16
            },
            {
              "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": 2.09,
              "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": 2.09,
              "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": 2.09,
              "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": 1.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.32
            },
            {
              "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": 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": 2.09,
              "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": 1.15
            },
            {
              "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": 1.34
            },
            {
              "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": 1.34
            },
            {
              "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": 1.36
            },
            {
              "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": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.78
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "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": 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": 1.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "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": 2.09,
              "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": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.09,
              "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": 1.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.15
            },
            {
              "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": 2.09,
              "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": 1.78
            },
            {
              "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": 1.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 0.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 2.09,
              "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": 1.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.36
            },
            {
              "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": 1.71
            },
            {
              "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": 2.09,
              "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": 2.09,
              "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": 1.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "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": 1.53
            },
            {
              "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": 2.09,
              "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": 1.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.53
            },
            {
              "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": 2.09,
              "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": 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": 1.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.57
            },
            {
              "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": 2.09,
              "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": 2.09,
              "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": 1.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "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": 2.09,
              "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": 2.09,
              "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": 2.09,
              "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": 1.78
            }
          ]
        }
      ]
    },
    {
      "description": "Lotion Moisturizing Secura 8 Oz Bottle",
      "code_information": [
        {
          "code": "PX-CH-UN59433400",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.74,
          "discounted_cash": 3.08,
          "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": 3.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.63
            },
            {
              "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": 2.63
            },
            {
              "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": 4.74,
              "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": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 4.03
            },
            {
              "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": 2.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 3.89
            },
            {
              "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": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 4.74,
              "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": 4.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.74,
              "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": 2.61
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 4.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.93
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 3.93
            },
            {
              "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": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 4.74,
              "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": 3.04
            },
            {
              "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": 3.04
            },
            {
              "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": 3.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 1.29
            },
            {
              "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": 4.74,
              "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": 4.74,
              "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": 4.74,
              "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": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 2.61
            },
            {
              "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": 4.74,
              "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": 4.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.03
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 4.74,
              "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": 2.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.04
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 3.09
            },
            {
              "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": 4.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.93
            },
            {
              "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": 4.03
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.74,
              "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": 3.09
            },
            {
              "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
            },
            {
              "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": 4.74,
              "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": 4.74,
              "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": 3.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 4.16
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 2.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.03
            },
            {
              "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": 3.04
            },
            {
              "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": 3.89
            },
            {
              "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": 3.04
            },
            {
              "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": 3.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.04
            },
            {
              "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": 3.89
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.74,
              "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": 4.74,
              "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": 3.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.04
            }
          ]
        }
      ]
    },
    {
      "description": "Oxygen Tubing Vinyl Tipped Crush Resistant Lumen 7 Ft",
      "code_information": [
        {
          "code": "PX-CH-55001302",
          "type": "CDM"
        },
        {
          "code": "A4616",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.72,
          "discounted_cash": 0.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.53
            },
            {
              "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": 0.63
            },
            {
              "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": 0.72,
              "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": 0.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.54
            },
            {
              "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": 0.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.47
            },
            {
              "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": 0.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.4
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.59
            },
            {
              "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": 0.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.53
            },
            {
              "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": 0.72,
              "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": 0.4
            },
            {
              "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": 0.53
            },
            {
              "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": 0.72,
              "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": 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": 0.46
            },
            {
              "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": 0.58
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.72,
              "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": 0.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.59
            },
            {
              "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": 0.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.46
            },
            {
              "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": 0.59
            },
            {
              "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": 0.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.61
            },
            {
              "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": 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": 0.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.72,
              "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": 0.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.72,
              "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": 0.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.4
            },
            {
              "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": 0.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.61
            },
            {
              "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": 0.72,
              "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": 0.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.72,
              "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": 0.72,
              "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": 0.46
            },
            {
              "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": 0.46
            },
            {
              "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": 0.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.61
            },
            {
              "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": 0.72,
              "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": 0.47
            },
            {
              "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": 0.63
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.72,
              "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": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.72,
              "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": 0.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.58
            }
          ]
        }
      ]
    },
    {
      "description": "Tranquility Premium Underwear Small 22 in - 36 In",
      "code_information": [
        {
          "code": "PX-CH-IMCPU2114",
          "type": "CDM"
        },
        {
          "code": "T4526",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.22,
          "discounted_cash": 0.79,
          "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": 0.78
            },
            {
              "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": 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": 1.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 1.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.04
            },
            {
              "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": 1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.22,
              "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": 1.22,
              "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": 1.22,
              "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": 1.04
            },
            {
              "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": 1.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.01
            },
            {
              "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": 1.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 0.89
            },
            {
              "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": 1.22,
              "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": 1.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.22,
              "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": 0.79
            },
            {
              "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": 0.68
            },
            {
              "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": 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": 1.22,
              "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": 1.04
            },
            {
              "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": 1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 0.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 1.22
            },
            {
              "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": 1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.92
            },
            {
              "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": 0.67
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 0.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 1.22,
              "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": 0.67
            },
            {
              "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": 1.22,
              "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": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.78
            },
            {
              "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": 1.22,
              "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": 0.77
            },
            {
              "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": 1.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.67
            },
            {
              "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": 0.78
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.22,
              "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": 0.92
            },
            {
              "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": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.78
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.22,
              "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": 1.04
            },
            {
              "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": 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": 1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.77
            },
            {
              "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": 1.22,
              "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": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.68
            },
            {
              "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": 1.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.68
            },
            {
              "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": 0.78
            },
            {
              "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": 0.78
            },
            {
              "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": 0.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.22,
              "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": 0.89
            }
          ]
        }
      ]
    },
    {
      "description": "HC RBC Dna Hea 35 Ag 11 Bld Grp So",
      "code_information": [
        {
          "code": "PX-30000060",
          "type": "CDM"
        },
        {
          "code": "0001U",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2030,
          "discounted_cash": 1319.5,
          "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": 1303.26
            },
            {
              "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": 1682.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1282.96
            },
            {
              "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": 2030,
              "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": 1303.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1126.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1522.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1664.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1481.9
            },
            {
              "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": 1664.6
            },
            {
              "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": 1664.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1682.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1682.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1321.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1282.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1116.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1481.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1642.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2030,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1321.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1321.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2030
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1116.5
            },
            {
              "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": 1481.9
            },
            {
              "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": 1303.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1786.4
            },
            {
              "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": 2030,
              "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": 1116.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "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": 1126.65
            },
            {
              "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": 1126.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "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": 1303.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1116.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1481.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1481.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1664.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1116.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "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": 1780.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1282.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "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": 554.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1522.5
            },
            {
              "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": 2030,
              "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": 2030,
              "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": 1664.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1319.5
            },
            {
              "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": 1282.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1303.26
            },
            {
              "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": 1321.53
            },
            {
              "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": 1642.27
            },
            {
              "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": 1126.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1664.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1522.5
            },
            {
              "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": 1282.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1780.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2700,
              "estimated_amount": 2700
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1725.5
            },
            {
              "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": 1116.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1664.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1481.9
            },
            {
              "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": 1725.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1282.96
            },
            {
              "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": 1321.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1664.6
            },
            {
              "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": 1725.5
            },
            {
              "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": 1282.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1282.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1116.5
            }
          ],
          "minimum": 2700,
          "maximum": 2700
        }
      ]
    },
    {
      "description": "Alginate Hydrocellular Kerracel 4 in X 5 In",
      "code_information": [
        {
          "code": "PX-CH-IMCCWL1033",
          "type": "CDM"
        },
        {
          "code": "A6197",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.57,
          "discounted_cash": 4.27,
          "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": 4.22
            },
            {
              "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": 5.58
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.58
            },
            {
              "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": 4.22
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC 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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 5.58
            },
            {
              "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": 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": "BUCKEYE COMMUNITY 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": "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": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 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": 5.39
            },
            {
              "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": "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 BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "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": 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": "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "AETNA [310]",
              "plan_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": "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "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": "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": "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN 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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 4.15
            },
            {
              "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": "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 [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": "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": "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": "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 BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "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": 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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "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": 6.57,
              "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": 3.65
            },
            {
              "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": "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": "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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "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": "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 GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "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": 1.79
            },
            {
              "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": 3.65
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "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 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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "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": 6.57,
              "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": 6.57,
              "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": 6.57,
              "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": 4.15
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "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": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "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": 4.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "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": 3.61
            },
            {
              "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": 6.57,
              "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": 6.57,
              "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": 6.57,
              "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": 4.8
            },
            {
              "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": 6.57,
              "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": 6.57,
              "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": 4.28
            },
            {
              "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": "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 [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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "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": 5.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "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": "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 OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 4.22
            },
            {
              "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": 6.57,
              "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": 5.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "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": "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            }
          ]
        }
      ]
    },
    {
      "description": "\"Cast Padding Webril 4\"\" X 4 Yds Non-Sterile\"",
      "code_information": [
        {
          "code": "PX-CH-KN3175",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.09,
          "discounted_cash": 1.36,
          "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": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.16
            },
            {
              "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": 2.09,
              "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": 1.78
            },
            {
              "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": 1.71
            },
            {
              "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": 1.71
            },
            {
              "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": 2.09,
              "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": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.34
            },
            {
              "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": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 2.09,
              "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": 1.78
            },
            {
              "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": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.36
            },
            {
              "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": 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": 2.09,
              "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": 1.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.73
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "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": 1.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.71
            },
            {
              "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": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 2.09,
              "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": 1.53
            },
            {
              "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": 1.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "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": 1.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 2.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.09,
              "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": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.53
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "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": 1.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 1.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.15
            },
            {
              "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": 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": 1.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "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": 1.71
            },
            {
              "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": 2.09,
              "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": 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": 1.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.09,
              "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": 2.09,
              "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": 1.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.32
            },
            {
              "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": 1.15
            },
            {
              "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": 1.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.15
            }
          ]
        }
      ]
    },
    {
      "description": "Island Composite Drsg Adhesive Primapore 2 in X 3 In",
      "code_information": [
        {
          "code": "PX-CH-UN7133-00",
          "type": "CDM"
        },
        {
          "code": "A6254",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.5,
          "discounted_cash": 0.32,
          "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": 0.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.43
            },
            {
              "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": 0.43
            },
            {
              "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": 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": 0.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.33
            },
            {
              "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": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.5,
              "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": 0.28
            },
            {
              "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": 0.32
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.37
            },
            {
              "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": 0.32
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.28
            },
            {
              "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": 0.28
            },
            {
              "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": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.32
            },
            {
              "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": 0.33
            },
            {
              "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": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.5,
              "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": 0.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.32
            },
            {
              "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": 0.44
            },
            {
              "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": 0.5,
              "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": 0.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.32
            },
            {
              "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": 0.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.28
            },
            {
              "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": 0.5,
              "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": 0.5,
              "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": 0.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.32
            },
            {
              "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": 0.37
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.41
            },
            {
              "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": 0.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.28
            },
            {
              "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": 0.14
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.5,
              "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": 0.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.5,
              "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": 0.41
            },
            {
              "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": 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": 0.37
            },
            {
              "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": 0.5,
              "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": 0.5,
              "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": 0.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.33
            },
            {
              "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": 0.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.32
            },
            {
              "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": 0.5,
              "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": 0.32
            },
            {
              "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": 0.4
            },
            {
              "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": 0.5,
              "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": 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": 0.5,
              "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": 0.5,
              "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": 0.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.28
            }
          ]
        }
      ]
    },
    {
      "description": "Ide G150057 Aaa 13-03 Gore Excluder Aortic Ext Endo",
      "code_information": [
        {
          "code": "PX-62400195",
          "type": "CDM"
        },
        {
          "code": "C1874",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2500,
          "discounted_cash": 1625,
          "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": 1605
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2050
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1875
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2125
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2500
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2125
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1375
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1825
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 1375
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2022.5
            },
            {
              "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": 2050
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1387.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2072.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2050
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2125
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2200
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2125
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2125
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 1627.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2125
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2500,
              "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": 1580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1580
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2022.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1627.5
            },
            {
              "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": 1580
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2500,
              "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": 2500,
              "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": 2500,
              "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": 1627.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 682.5
            },
            {
              "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": 1580
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2125
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1825
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 2072.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1875
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 2500,
              "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": 1387.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2500,
              "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": 2500,
              "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": 1375
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2192.5
            },
            {
              "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": 1627.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2050
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2125
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2125
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2050
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2072.5
            },
            {
              "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": 547.5
            },
            {
              "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": 1605
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1825
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 1580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1580
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2050
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2500,
              "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": 2125
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1387.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2125
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1375
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 1580
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2500,
              "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": 2500,
              "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": 2125
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1375
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1875
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 1387.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2050
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1825
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1825
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1825
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2500,
              "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": 2125
            },
            {
              "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": 2500,
              "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": 2500,
              "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": 1375
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1605
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2192.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 1375
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1625
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1580
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2500,
              "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": 2500,
              "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": 2500,
              "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": 2050
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 2125
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2500,
              "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": 1605
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1627.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2500,
              "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": 2500,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter External Latex Medium 29mm Standard Wear",
      "code_information": [
        {
          "code": "PX-CH-HO9607",
          "type": "CDM"
        },
        {
          "code": "A4349",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.91,
          "discounted_cash": 1.24,
          "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": 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": 1.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 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": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.23
            },
            {
              "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": 1.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.57
            },
            {
              "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": 1.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "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": 1.21
            },
            {
              "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": 1.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.57
            },
            {
              "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": 1.91,
              "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": 1.05
            },
            {
              "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": 1.91,
              "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": 1.91,
              "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": 1.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.06
            },
            {
              "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": 1.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.05
            },
            {
              "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": 1.39
            },
            {
              "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": 1.91,
              "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": 1.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.24
            },
            {
              "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": 1.57
            },
            {
              "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": 1.91,
              "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": 1.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 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": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.39
            },
            {
              "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": 1.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 1.62
            },
            {
              "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": 0.52
            },
            {
              "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": 1.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.39
            },
            {
              "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": 1.05
            },
            {
              "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": 1.57
            },
            {
              "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": 1.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "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": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.91,
              "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": 1.62
            },
            {
              "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": 1.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "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": 1.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.39
            },
            {
              "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": 1.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.91,
              "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": 1.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 1.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.91,
              "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": 1.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.57
            },
            {
              "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": 1.91,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Gloves Latex Free Powder-Free Sterile Medium",
      "code_information": [
        {
          "code": "PX-CH-MZMDS194065",
          "type": "CDM"
        },
        {
          "code": "A4930",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.61,
          "discounted_cash": 0.4,
          "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": 0.39
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.45
            },
            {
              "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": 0.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.5
            },
            {
              "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": 0.54
            },
            {
              "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": "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.61,
              "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": 0.52
            },
            {
              "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": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.52
            },
            {
              "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": 0.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.4
            },
            {
              "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": 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": 0.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.34
            },
            {
              "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": 0.45
            },
            {
              "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": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.39
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            },
            {
              "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": 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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.61,
              "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": 0.4
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.46
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "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": 0.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "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": 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": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.5
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            },
            {
              "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": 0.39
            },
            {
              "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": 0.61,
              "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": 0.34
            },
            {
              "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": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.39
            },
            {
              "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": 0.61,
              "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": 0.52
            },
            {
              "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": 0.34
            },
            {
              "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": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.34
            },
            {
              "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": 0.34
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Rings Convex Oval Adapt 1 1/2 in X 2 1/4 In",
      "code_information": [
        {
          "code": "PX-CH-HO79603",
          "type": "CDM"
        },
        {
          "code": "A4411",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.74,
          "discounted_cash": 3.73,
          "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": 3.69
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "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": 4.19
            },
            {
              "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": 5.74,
              "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": 5.74,
              "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": 4.71
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 4.71
            },
            {
              "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": 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": 3.69
            },
            {
              "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": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 5.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.19
            },
            {
              "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": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 3.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.88
            },
            {
              "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": 5.74,
              "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": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "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": 5.74,
              "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": 4.31
            },
            {
              "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": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.71
            },
            {
              "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": 5.74,
              "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": 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": 3.19
            },
            {
              "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": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 3.16
            },
            {
              "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": 4.88
            },
            {
              "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": 3.19
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "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": 5.74,
              "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": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.71
            },
            {
              "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": 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": 4.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.88
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 4.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.74,
              "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": 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": 4.88
            },
            {
              "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 3.74
            },
            {
              "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": 5.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.88
            },
            {
              "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": 5.74,
              "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": 3.63
            },
            {
              "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": 5.74,
              "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": 4.88
            },
            {
              "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": 3.69
            },
            {
              "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": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 3.19
            },
            {
              "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": 3.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.19
            },
            {
              "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": 5.74,
              "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": 4.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.19
            },
            {
              "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": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.71
            },
            {
              "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": 5.74,
              "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": 5.74,
              "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": 5.03
            },
            {
              "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": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 5.74
            },
            {
              "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": 3.69
            },
            {
              "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": 3.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.88
            },
            {
              "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": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.88
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ide G150107 Amaze Lariat-Rs Suture Delivery Device",
      "code_information": [
        {
          "code": "PX-62400197",
          "type": "CDM"
        },
        {
          "code": "C1889",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7950,
          "discounted_cash": 5167.5,
          "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": 5103.9
            },
            {
              "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": 5103.9
            },
            {
              "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": 7950,
              "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": 7950,
              "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": 6757.5
            },
            {
              "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": 7950,
              "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": 6757.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5103.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5103.9
            },
            {
              "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": 7950,
              "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": 6590.55
            },
            {
              "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": 6972.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5024.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 5175.45
            },
            {
              "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": 7950,
              "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": 7950,
              "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": 7950,
              "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": 6431.55
            },
            {
              "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": 7950,
              "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": 4372.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 7950,
              "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": 4412.25
            },
            {
              "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": 4412.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5103.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5803.5
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 5103.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5024.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 7950,
              "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": 6757.5
            },
            {
              "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": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5024.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 6590.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5103.9
            },
            {
              "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": 5175.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5024.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 6757.5
            },
            {
              "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": 5167.5
            },
            {
              "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": 4372.5
            },
            {
              "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": 5803.5
            },
            {
              "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": 7950,
              "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": 7950,
              "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": 6757.5
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "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": 1741.05
            },
            {
              "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": 7950,
              "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": 7950,
              "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": 6519
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7950,
              "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": 4412.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 5175.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 5103.9
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5103.9
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7950,
              "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": 6757.5
            },
            {
              "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": 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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7950,
              "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": 7950,
              "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": 7950,
              "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": 7950,
              "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": 5103.9
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5024.4
            },
            {
              "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": 7950,
              "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": 5962.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7950,
              "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": 6757.5
            },
            {
              "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": 6996
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5962.5
            },
            {
              "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": 5024.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 2170.35
            },
            {
              "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": 5024.4
            },
            {
              "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": 7950,
              "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": 5024.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7950,
              "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": 7950,
              "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": 4372.5
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5103.9
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "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": 6519
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7950,
              "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": 5175.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7950,
              "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": 5103.9
            },
            {
              "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": 6431.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC Affinity 6.25 Cm PR Sq Cm",
      "code_information": [
        {
          "code": "PX-63600060",
          "type": "CDM"
        },
        {
          "code": "Q4159",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1082,
          "discounted_cash": 703.3,
          "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": 694.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 887.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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,
              "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": 948.91
            },
            {
              "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": 948.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1082,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 595.1
            },
            {
              "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": 683.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "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": 595.1
            },
            {
              "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": 694.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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,
              "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": 919.7
            },
            {
              "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": 704.38
            },
            {
              "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": 887.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 887.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 919.7
            },
            {
              "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": 1082,
              "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": 1082,
              "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": 1082,
              "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": 683.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.82
            },
            {
              "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": 1082,
              "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": 811.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 789.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694.64
            },
            {
              "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": 887.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 1082,
              "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": 236.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.86
            },
            {
              "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": 1082,
              "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": 887.24
            },
            {
              "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": 600.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 595.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 1082,
              "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": 704.38
            },
            {
              "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": 1082,
              "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": 811.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 887.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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,
              "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": 694.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 1082,
              "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": 1082
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "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": 919.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 595.1
            },
            {
              "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": 683.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 1082,
              "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": 875.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 600.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "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": 1082,
              "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": 683.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 896.98
            },
            {
              "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": 1082,
              "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": 919.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 811.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.82
            },
            {
              "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": 694.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 704.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 595.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 919.7
            },
            {
              "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": 896.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 704.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 887.24
            },
            {
              "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": 1082,
              "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": 1082,
              "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": 1082,
              "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": 1082,
              "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": 1082,
              "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": 919.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 595.1
            },
            {
              "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": 1082,
              "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": 1082,
              "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": 600.51
            },
            {
              "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": 703.3
            },
            {
              "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": 952.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 896.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 1082,
              "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": 1082,
              "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": 789.86
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "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": 600.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 919.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "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": 595.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 875.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1082,
              "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": 694.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 704.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.86
            },
            {
              "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": 694.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694.64
            },
            {
              "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": 694.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 887.24
            },
            {
              "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": 295.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1082,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Lubricath Silver 16 Fr 5 Cc Coude",
      "code_information": [
        {
          "code": "PX-CH-BA0102SI16",
          "type": "CDM"
        },
        {
          "code": "A4340",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 38.97,
          "discounted_cash": 25.33,
          "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": 25.02
            },
            {
              "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": 38.97,
              "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": 34.29
            },
            {
              "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": 21.63
            },
            {
              "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": 21.63
            },
            {
              "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": 31.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 33.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.63
            },
            {
              "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": 25.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.02
            },
            {
              "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": 38.97,
              "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": 38.97,
              "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": 38.97,
              "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": 38.97,
              "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": 38.97,
              "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": 25.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.53
            },
            {
              "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": 38.97,
              "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": 33.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.12
            },
            {
              "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": 38.97,
              "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": 31.96
            },
            {
              "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": 25.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 38.97,
              "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": 38.97,
              "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": 21.43
            },
            {
              "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": 28.45
            },
            {
              "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": 38.97,
              "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": 28.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 32.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.45
            },
            {
              "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": 38.97,
              "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": 24.63
            },
            {
              "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": 24.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.02
            },
            {
              "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": 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": 21.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 38.97,
              "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": 28.45
            },
            {
              "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": 38.97,
              "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": 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": 31.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 25.37
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.23
            },
            {
              "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": 38.97,
              "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": 24.63
            },
            {
              "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": 38.97,
              "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": 33.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.12
            },
            {
              "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": 25.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.43
            },
            {
              "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": 38.97,
              "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": 38.97,
              "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": 38.97,
              "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": 10.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 33.12
            },
            {
              "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": 38.97,
              "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": 31.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.97,
              "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": 38.97,
              "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": 25.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.02
            },
            {
              "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": 32.31
            },
            {
              "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": 24.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 33.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.02
            },
            {
              "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": 38.97,
              "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": 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": 21.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.31
            },
            {
              "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": 25.37
            },
            {
              "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": 31.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.97,
              "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": 28.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.97,
              "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": 38.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.97,
              "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": 38.97,
              "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": 38.97,
              "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": 31.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.63
            },
            {
              "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": 34.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.97,
              "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": 25.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.23
            },
            {
              "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": 25.37
            }
          ]
        }
      ]
    },
    {
      "description": "Tape Cloth Surgical 2 Inx10 Yd Reliamed",
      "code_information": [
        {
          "code": "PX-CH-IMCZTSC02",
          "type": "CDM"
        },
        {
          "code": "A4452",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.28,
          "discounted_cash": 2.78,
          "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": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.79
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "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": 2.38
            },
            {
              "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": 3.55
            },
            {
              "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": 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": 2.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.7
            },
            {
              "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": 2.38
            },
            {
              "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": 4.28,
              "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": 4.28,
              "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": 4.28,
              "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": 3.46
            },
            {
              "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": 4.28,
              "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": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 3.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.51
            },
            {
              "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": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 3.21
            },
            {
              "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": 4.28,
              "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": 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": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 2.7
            },
            {
              "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": 2.7
            },
            {
              "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": 4.28,
              "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": 4.28,
              "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": 4.28,
              "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": 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": 2.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.75
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.51
            },
            {
              "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": 2.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 3.64
            },
            {
              "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": 3.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.28,
              "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": 2.79
            },
            {
              "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": 3.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 3.21
            },
            {
              "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": 4.28,
              "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": 4.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 2.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.46
            },
            {
              "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": 3.51
            },
            {
              "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": 4.28,
              "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": 3.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 2.7
            },
            {
              "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": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 2.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 2.38
            },
            {
              "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": "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 [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 3.64
            },
            {
              "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": 2.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.55
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "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": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 4.28,
              "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": 4.28,
              "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": 4.28,
              "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": 4.28,
              "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": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.75
            },
            {
              "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": 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": 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": 1.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.12
            },
            {
              "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": "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": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.51
            },
            {
              "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": 3.51
            },
            {
              "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 DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.28,
              "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": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 3.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.51
            },
            {
              "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": 3.64
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 2.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.79
            },
            {
              "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": 1.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.75
            },
            {
              "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": 2.75
            },
            {
              "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": "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": "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": "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": 4.28,
              "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": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.75
            },
            {
              "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": 3.51
            },
            {
              "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": "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 OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "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": 3.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "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": 4.28,
              "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": 3.12
            },
            {
              "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": 3.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 2.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.75
            },
            {
              "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": 2.75
            },
            {
              "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": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 3.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 4.28
            },
            {
              "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": 2.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.64
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 2.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 2.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 3.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.64
            },
            {
              "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": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 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": 3.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 4.28,
              "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": 2.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 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": 3.12
            },
            {
              "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": 4.28,
              "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": 2.75
            },
            {
              "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": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.28,
              "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": 4.28,
              "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": 2.79
            },
            {
              "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": 4.28,
              "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": 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": 2.7
            },
            {
              "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": 2.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.79
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 11.02,
          "discounted_cash": 7.16,
          "payers_information": [
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.37
            },
            {
              "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": 6.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 7.07
            },
            {
              "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": 11.02,
              "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": 6.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.15
            },
            {
              "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": 11.02,
              "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": 8.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 9.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.37
            },
            {
              "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": 9.7
            },
            {
              "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": 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": 6.96
            },
            {
              "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": 6.06
            },
            {
              "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": 8.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.37
            },
            {
              "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": 6.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.06
            },
            {
              "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": 9.66
            },
            {
              "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": 7.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.02,
              "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": 9.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 7.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.04
            },
            {
              "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": 7.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 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": 8.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.17
            },
            {
              "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": 3.01
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.02,
              "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": 9.66
            },
            {
              "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": 9.04
            },
            {
              "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": 9.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.07
            },
            {
              "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": 6.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 9.04
            },
            {
              "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": 7.07
            },
            {
              "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": 7.07
            },
            {
              "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": 6.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "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": 11.02,
              "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": 8.27
            },
            {
              "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": 6.92
            },
            {
              "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": 9.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.07
            },
            {
              "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": 9.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 6.12
            },
            {
              "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": 6.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 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": 6.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 8.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "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": 6.06
            },
            {
              "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": 9.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.92
            },
            {
              "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": 7.17
            },
            {
              "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": 9.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.37
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ide G150200 Pinnacle Flex Watchman Closure Device",
      "code_information": [
        {
          "code": "PX-62400199",
          "type": "CDM"
        },
        {
          "code": "C1889",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1,
          "discounted_cash": 0.65,
          "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": 0.64
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 1,
              "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": 0.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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,
              "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": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 0.83
            },
            {
              "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": 1,
              "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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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,
              "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,
              "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": 0.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 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": 0.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 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": 0.64
            },
            {
              "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": 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": 0.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "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": 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": 0.56
            },
            {
              "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": 1,
              "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,
              "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": 0.55
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1,
              "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": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1,
              "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": 0.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.73
            },
            {
              "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": 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": 0.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 0.73
            },
            {
              "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": 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": 0.82
            },
            {
              "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,
              "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": 0.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "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": 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": 0.73
            },
            {
              "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": 0.73
            },
            {
              "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": 1,
              "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": 0.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.64
            },
            {
              "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": 0.64
            },
            {
              "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": 0.82
            },
            {
              "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": 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": 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": 1,
              "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,
              "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,
              "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,
              "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": 0.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.82
            },
            {
              "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": 0.82
            },
            {
              "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": 1,
              "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": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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": 1,
              "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": 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": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "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": 1,
              "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,
              "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": 0.73
            },
            {
              "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": 1,
              "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
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 0.85
            },
            {
              "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,
              "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": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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": 0.65
            },
            {
              "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": 1,
              "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": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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,
              "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,
              "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": 0.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1,
              "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": 0.56
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Foam Drsg Non-Adhesive Hydrofera Blue 6\"\" X 6\"\" Blue\"",
      "code_information": [
        {
          "code": "PX-CH-ADVOHB6614",
          "type": "CDM"
        },
        {
          "code": "A6210",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22.34,
          "discounted_cash": 14.52,
          "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": 14.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 14.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.99
            },
            {
              "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": 22.34,
              "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": 16.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 22.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 6.1
            },
            {
              "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": 14.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.99
            },
            {
              "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": 22.34,
              "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": 22.34,
              "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": 18.99
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 22.34,
              "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": 12.29
            },
            {
              "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": 16.31
            },
            {
              "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": 22.34,
              "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": 18.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.54
            },
            {
              "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": 18.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 22.34,
              "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": 22.34,
              "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": 18.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 16.31
            },
            {
              "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": 14.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.52
            },
            {
              "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": 12.4
            },
            {
              "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": 22.34,
              "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": 12.4
            },
            {
              "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": 18.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.99
            },
            {
              "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": 22.34,
              "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": 14.34
            },
            {
              "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": 12.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.52
            },
            {
              "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": 19.66
            },
            {
              "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": 22.34,
              "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": 22.34,
              "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": 14.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 22.34,
              "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": 22.34,
              "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": 22.34,
              "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": 12.29
            },
            {
              "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": 14.54
            },
            {
              "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": 12.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 22.34,
              "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": 22.34,
              "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": 14.54
            },
            {
              "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": 22.34,
              "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": 22.34,
              "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": 18.99
            },
            {
              "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": 18.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.29
            },
            {
              "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": 22.34,
              "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": 18.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.99
            },
            {
              "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": 14.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.31
            },
            {
              "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": 22.34,
              "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": 14.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 14.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 14.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.07
            },
            {
              "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": 19.59
            },
            {
              "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": 14.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.99
            },
            {
              "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": 22.34,
              "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": 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": 18.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 22.34,
              "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": 16.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.34,
              "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": 22.34,
              "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": 22.34,
              "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": 22.34,
              "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": 19.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22.34,
              "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": 18.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 14.12
            },
            {
              "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": 12.4
            },
            {
              "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": 18.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.32
            },
            {
              "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": 22.34,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter 3-Way Lubricious 22fr 30 Cc",
      "code_information": [
        {
          "code": "PX-CH-BA0167L22",
          "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": "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": "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": "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "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": "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": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.57
            },
            {
              "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": "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": "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": "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 OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "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 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 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": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "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": 23.88
            },
            {
              "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": "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": "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 27.23,
              "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": 19.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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 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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "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": 23.96
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "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": 17.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 27.23,
              "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": 15.11
            },
            {
              "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": "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": "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.57
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "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": "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": "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": "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": "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/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 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": "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": "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 MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 27.23,
              "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": 14.98
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.73
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 27.23
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "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": 14.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.88
            },
            {
              "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": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "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": "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": "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 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "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"
            },
            {
              "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": "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": "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": "HUMANA [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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "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": 23.15
            },
            {
              "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": 22.33
            },
            {
              "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"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Contact Drsg Sorbact Cutimed 4\"\" X 4\"\" Layer\"",
      "code_information": [
        {
          "code": "PX-CH-BI7266201",
          "type": "CDM"
        },
        {
          "code": "A6206",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.49,
          "discounted_cash": 6.17,
          "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": 6.09
            },
            {
              "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": 2.59
            },
            {
              "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": 9.49,
              "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": 8.32
            },
            {
              "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": 6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.07
            },
            {
              "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": 5.27
            },
            {
              "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": 7.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.93
            },
            {
              "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": 6.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 9.49,
              "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": 9.49,
              "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": 9.49,
              "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
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.07
            },
            {
              "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": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 5.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.78
            },
            {
              "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": 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": 7.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 6.93
            },
            {
              "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": 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": 7.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.12
            },
            {
              "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": 9.49,
              "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": 6.09
            },
            {
              "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": 6.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 9.49,
              "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": 9.49,
              "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": 8.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 9.49,
              "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": 7.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.09
            },
            {
              "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": 8.07
            },
            {
              "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": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 9.49,
              "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": 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": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 6.09
            },
            {
              "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": 6.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.22
            },
            {
              "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": 9.49,
              "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": 6.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 5.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 7.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.49,
              "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": 6.09
            },
            {
              "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": 5.27
            },
            {
              "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": 7.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.09
            },
            {
              "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": 6.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 9.49,
              "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": 9.49,
              "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": 8.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.49,
              "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": 6.93
            },
            {
              "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": 9.49,
              "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": 9.49,
              "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": 9.49,
              "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": 8.07
            },
            {
              "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": 8.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.49
            },
            {
              "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": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 9.49,
              "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": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.18
            },
            {
              "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": 7.68
            },
            {
              "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": 5.27
            },
            {
              "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": 7.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.12
            },
            {
              "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": 9.49,
              "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": 64.2,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.49,
              "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": 5.22
            },
            {
              "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": 9.49,
              "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": 9.49,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter External All Silicone 30mm Conveen Optima Standard",
      "code_information": [
        {
          "code": "PX-CH-CO22030",
          "type": "CDM"
        },
        {
          "code": "A4349",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.28,
          "discounted_cash": 1.48,
          "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": 1.46
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "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": 2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.87
            },
            {
              "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": 1.48
            },
            {
              "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": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 1.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.87
            },
            {
              "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": 1.87
            },
            {
              "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": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 1.66
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 2.28,
              "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": 1.48
            },
            {
              "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": 2.28,
              "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": 2.28,
              "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": 2.28,
              "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": 1.89
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "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": 1.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.71
            },
            {
              "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": 1.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.87
            },
            {
              "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": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.89
            },
            {
              "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": 1.27
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.87
            },
            {
              "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": 2.28,
              "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": 1.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "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": 1.94
            },
            {
              "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": 1.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 1.46
            },
            {
              "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": 1.89
            },
            {
              "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": 2.28,
              "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": 1.94
            },
            {
              "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": 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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.28,
              "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": 1.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 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": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 1.44
            },
            {
              "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/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 1.66
            },
            {
              "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": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 1.27
            },
            {
              "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 MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.28,
              "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": 2.28,
              "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": 2.28,
              "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": 1.46
            },
            {
              "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.87
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "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": 2.28,
              "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": 2.28,
              "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": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Underpad 30 in X 36 in Premium, Kendall Wings",
      "code_information": [
        {
          "code": "PX-CH-KN3036PS",
          "type": "CDM"
        },
        {
          "code": "A4554",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.15,
          "discounted_cash": 0.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 0.94
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.01
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 1.15,
              "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": 0.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.93
            },
            {
              "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": 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": 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": 0.84
            },
            {
              "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": 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": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.94
            },
            {
              "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": 0.73
            },
            {
              "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": 1.01
            },
            {
              "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": 1.15,
              "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": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "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": 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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.94
            },
            {
              "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": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.15,
              "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": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.98
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.98
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "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": 0.64
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.93
            },
            {
              "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": 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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.75
            },
            {
              "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": 0.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "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": 1.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.94
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "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": 1.01
            },
            {
              "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": 1.01
            },
            {
              "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": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 0.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 0.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "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": 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": 0.74
            },
            {
              "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": 0.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "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": 0.31
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15
            },
            {
              "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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.98
            },
            {
              "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": 1.15,
              "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": 1.15,
              "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": 1.15,
              "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": 0.98
            },
            {
              "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": "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": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 0.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.94
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 1.15,
              "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": 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": 0.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 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": 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": 0.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.15
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "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": 0.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.63
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 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": 0.94
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 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": 0.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 1.15,
              "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": 0.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.75
            },
            {
              "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": 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": 0.98
            },
            {
              "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": 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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.84
            },
            {
              "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": 0.84
            },
            {
              "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": 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": 0.84
            },
            {
              "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": 1.15,
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 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": 0.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.64
            },
            {
              "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": 1.15,
              "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": 0.98
            },
            {
              "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 PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.84
            },
            {
              "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": 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": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 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": 1.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.74
            },
            {
              "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": 0.75
            }
          ]
        }
      ]
    },
    {
      "description": "Powder Zeasorb Antifungal 2-1/2 Oz",
      "code_information": [
        {
          "code": "PX-CH-PH1392323",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.06,
          "discounted_cash": 6.54,
          "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": 6.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 8.25
            },
            {
              "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": 8.25
            },
            {
              "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": 8.25
            },
            {
              "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": 8.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 10.06,
              "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": 10.06,
              "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": 10.06,
              "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": 6.46
            },
            {
              "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": 8.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 10.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.34
            },
            {
              "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": 8.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 5.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 8.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "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": 6.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.25
            },
            {
              "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": 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": 6.36
            },
            {
              "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": 5.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 8.55
            },
            {
              "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": 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": 6.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 5.58
            },
            {
              "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": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 7.55
            },
            {
              "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": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.53
            },
            {
              "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": 6.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.55
            },
            {
              "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": 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": 8.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 10.06,
              "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": 5.53
            },
            {
              "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": 6.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 8.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 6.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.55
            },
            {
              "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": 5.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 8.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.25
            },
            {
              "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": 5.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 10.06,
              "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": 5.53
            },
            {
              "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": 7.34
            },
            {
              "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": 6.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.46
            },
            {
              "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": 6.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.55
            },
            {
              "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": 8.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 8.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.55
            },
            {
              "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": 8.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.25
            },
            {
              "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": 2.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.06
            },
            {
              "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": 6.36
            },
            {
              "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": 8.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.36
            },
            {
              "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": 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": 8.14
            },
            {
              "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": 6.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.25
            },
            {
              "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": 10.06,
              "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": 6.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "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": 6.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 8.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 6.36
            },
            {
              "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": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 6.55
            },
            {
              "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": 7.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "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": 8.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.55
            },
            {
              "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": 8.25
            },
            {
              "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": 2.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 8.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.55
            },
            {
              "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": 6.46
            },
            {
              "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": 6.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.06,
              "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": 8.55
            },
            {
              "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": 6.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 8.25
            },
            {
              "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": 10.06,
              "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": 7.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 8.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.06,
              "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": 10.06,
              "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": 10.06,
              "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": 8.55
            },
            {
              "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": 6.46
            },
            {
              "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": 5.53
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Youth Extra Small",
      "code_information": [
        {
          "code": "PX-CHHDI2166",
          "type": "CDM"
        },
        {
          "code": "T4534",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.77,
          "discounted_cash": 0.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.49
            },
            {
              "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": 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": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.77,
              "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": 0.77,
              "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": 0.42
            },
            {
              "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": 0.49
            },
            {
              "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": 0.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.77,
              "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": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.64
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.49
            },
            {
              "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": 0.49
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.62
            },
            {
              "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": 0.63
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.5
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.65
            },
            {
              "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": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.5
            },
            {
              "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": 0.63
            },
            {
              "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": 0.77,
              "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": 0.42
            },
            {
              "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": 0.77,
              "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": 0.77,
              "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": 0.77,
              "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": 0.65
            },
            {
              "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": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.77,
              "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": 0.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.49
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.77,
              "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": 0.77,
              "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": 0.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.49
            },
            {
              "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": 0.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.58
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.77,
              "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": 0.63
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.42
            },
            {
              "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": 0.49
            },
            {
              "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": 0.77,
              "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": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.63
            },
            {
              "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": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.77,
              "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": 0.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.42
            },
            {
              "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": 0.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.49
            },
            {
              "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": 0.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.49
            },
            {
              "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": 0.62
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.49
            },
            {
              "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": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.49
            },
            {
              "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": 0.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.58
            },
            {
              "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": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.21
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.65
            },
            {
              "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": 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": 0.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.65
            },
            {
              "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": 0.77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.77,
              "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": 0.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.77,
              "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": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.42
            },
            {
              "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": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.63
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.77,
              "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": 0.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.77,
              "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": 0.62
            },
            {
              "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": 0.63
            },
            {
              "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": 0.43
            },
            {
              "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": 0.43
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.77,
              "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": 0.77,
              "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": 0.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.77,
              "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": 0.49
            },
            {
              "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": 0.21
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 5.72,
          "discounted_cash": 3.72,
          "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": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 4.86
            },
            {
              "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": 4.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 3.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 4.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.62
            },
            {
              "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": 3.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 5.72,
              "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": 5.72,
              "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": 3.72
            },
            {
              "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": 3.67
            },
            {
              "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": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 5.72,
              "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": 4.74
            },
            {
              "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": 4.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 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": 4.18
            },
            {
              "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": 5.72,
              "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": 5.72,
              "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": 3.72
            },
            {
              "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": 3.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 3.67
            },
            {
              "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": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 5.72,
              "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": 4.29
            },
            {
              "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": 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": 4.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.72
            },
            {
              "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": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 4.86
            },
            {
              "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": 3.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 3.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.15
            },
            {
              "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": 4.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 3.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.67
            },
            {
              "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": 5.03
            },
            {
              "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": 3.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 3.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 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": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.72,
              "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": 5.72,
              "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": 4.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 3.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.72,
              "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": 3.67
            },
            {
              "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": 3.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 4.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 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": 3.62
            },
            {
              "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": 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": 1.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.86
            }
          ]
        }
      ]
    },
    {
      "description": "Ted Stocking Knee-Length Xxxl Regular",
      "code_information": [
        {
          "code": "PX-CHKN7472LF",
          "type": "CDM"
        },
        {
          "code": "A6549",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.53,
          "discounted_cash": 7.49,
          "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": 7.4
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 6.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.29
            },
            {
              "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": "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": "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 6.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.53,
              "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": 7.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 8.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 6.4
            },
            {
              "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": 10.11
            },
            {
              "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": 9.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 9.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": 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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.33
            },
            {
              "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": 7.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "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": 3.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 11.53,
              "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": 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": 9.8
            },
            {
              "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": 7.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.29
            },
            {
              "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": 10.11
            },
            {
              "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": 7.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 11.53,
              "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": 7.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.51
            },
            {
              "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": 9.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 11.53,
              "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": 11.53,
              "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": 7.29
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 9.45
            },
            {
              "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": 3.15
            },
            {
              "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": 9.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.4
            },
            {
              "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": 6.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 11.53,
              "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": 7.51
            },
            {
              "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": 7.51
            },
            {
              "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 OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "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": 7.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": 10.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 11.53,
              "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": 9.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": 9.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": 6.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.53
            },
            {
              "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": 7.29
            },
            {
              "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": 7.29
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": 7.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.51
            },
            {
              "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": 11.53,
              "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": 9.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": 10.15
            },
            {
              "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": 7.4
            },
            {
              "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": 9.45
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.4
            },
            {
              "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": 11.53,
              "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": 7.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "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": 8.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.29
            },
            {
              "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": 10.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 9.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "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": 7.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 9.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 9.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 11.53,
              "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": 11.53,
              "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": 9.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.29
            },
            {
              "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": 7.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "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": 6.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 10.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "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": 9.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.53,
              "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": 7.29
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 11.53,
              "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": 9.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "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": 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": 9.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.8
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 7.4
            },
            {
              "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": 7.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.65
            },
            {
              "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 OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 9.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 7.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.53,
              "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": 6.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.42
            }
          ]
        }
      ]
    },
    {
      "description": "\"Heel Protector Heelbo Lrg Up to 19\"\" Limb Cardinal\"",
      "code_information": [
        {
          "code": "PX-CHZGHEPLRG",
          "type": "CDM"
        },
        {
          "code": "E0191",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.22,
          "discounted_cash": 9.89,
          "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": 9.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 13.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 15.22,
              "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": 9.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 15.22,
              "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": 9.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "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": 12.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "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": 8.37
            },
            {
              "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": 9.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 12.94
            },
            {
              "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": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 12.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "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": 9.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 11.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": 9.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 9.77
            },
            {
              "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": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 8.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 15.22,
              "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": 12.94
            },
            {
              "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "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": 8.45
            },
            {
              "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": 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": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 12.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 11.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 12.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 12.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.22
            },
            {
              "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": 12.62
            },
            {
              "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": 15.22,
              "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": 11.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "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": 4.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "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": 15.22,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 12.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 12.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 12.94
            },
            {
              "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": 9.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "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": 11.11
            },
            {
              "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": 13.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "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": 13.39
            },
            {
              "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": 9.77
            },
            {
              "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": 9.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.62
            },
            {
              "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": 12.48
            },
            {
              "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": 13.35
            },
            {
              "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": 9.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": 9.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.31
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 12.94
            },
            {
              "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": 8.45
            },
            {
              "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": 13.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 12.94
            },
            {
              "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": 9.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 12.48
            },
            {
              "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": 8.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 15.22,
              "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": 15.22,
              "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": 11.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "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": 9.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "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": 12.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "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": 12.94
            },
            {
              "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "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": 9.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 11.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 12.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.62
            },
            {
              "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": 9.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 11.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.11
            },
            {
              "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": 12.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 12.48
            },
            {
              "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": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": 12.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.22,
              "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": 15.22,
              "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": 13.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.77
            },
            {
              "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": 9.77
            },
            {
              "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": 9.77
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.94
            },
            {
              "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": 12.31
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mra Upper Extremity W Contrast",
      "code_information": [
        {
          "code": "PX-61800013",
          "type": "CDM"
        },
        {
          "code": "73225",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2050,
          "discounted_cash": 1332.5,
          "payers_information": [
            {
              "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": 1508.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1127.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1496.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 2050,
              "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": 1742.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "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": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1537.5
            },
            {
              "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": 335.65,
              "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": 2050,
              "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": 2050,
              "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": 2050,
              "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": 2050,
              "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": 1699.45
            },
            {
              "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": 1681
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1681
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1681
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 342.5,
              "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": 1537.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 339.01,
              "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": 73.5,
              "estimated_amount": 1506.75
            },
            {
              "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": 1500.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "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": 1508.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1537.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1334.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1334.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2050
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1500.6
            },
            {
              "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": 1508.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1127.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1500.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1334.55
            },
            {
              "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": 1681
            },
            {
              "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": 1500.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1500.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 335.65,
              "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": 448.95
            },
            {
              "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": 2050,
              "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": 1797.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 339.01,
              "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": 1681
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "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": 335.65,
              "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_dollar": 246.7,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 259.04,
              "additional_payer_notes": "PHYSICIAN 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": 1699.45
            },
            {
              "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": 1742.5
            },
            {
              "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": 1506.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "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": 1658.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "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": 1332.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1127.5
            },
            {
              "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": 2050,
              "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": 1127.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "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": 1334.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1506.75
            },
            {
              "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": 339.01,
              "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": 335.65,
              "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": 73.2,
              "estimated_amount": 1500.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1496.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1500.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 342.5,
              "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": 2050,
              "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": 1699.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1496.5
            },
            {
              "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": 559.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1496.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1496.5
            },
            {
              "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": 352.43,
              "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": 1742.5
            },
            {
              "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": 1804
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 1742.5
            },
            {
              "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": 1500.6
            },
            {
              "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": 1496.5
            },
            {
              "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": 352.43,
              "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": 339.01,
              "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": 1506.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1658.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1127.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 1742.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1681
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1127.5
            },
            {
              "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": 339.01,
              "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": 1334.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2050,
              "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": 2050,
              "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": 342.5,
              "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": 2050,
              "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": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1681
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1681
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1742.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1508.8
            },
            {
              "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": 1797.85
            },
            {
              "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": 2050,
              "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": 1127.5
            }
          ],
          "minimum": 246.7,
          "maximum": 246.7
        }
      ]
    },
    {
      "description": "2 Pc Pouch 2 1/4 in Sur-Fit High Output",
      "code_information": [
        {
          "code": "PX-CHCV420696",
          "type": "CDM"
        },
        {
          "code": "A4413",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.31,
          "discounted_cash": 2.15,
          "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": 2.13
            },
            {
              "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": 2.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.42
            },
            {
              "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": 3.31,
              "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": 2.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 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": 2.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 2.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 2.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 2.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 3.31,
              "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": 3.31,
              "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": 2.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "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": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.13
            },
            {
              "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": 2.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 3.31,
              "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": 3.31,
              "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": 3.31,
              "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": 2.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.31,
              "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": 3.31,
              "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": 2.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.13
            },
            {
              "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": 2.13
            },
            {
              "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": 0.9
            },
            {
              "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": 2.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "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": 2.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            },
            {
              "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": 2.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.09
            },
            {
              "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": 2.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.48
            },
            {
              "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": 2.09
            },
            {
              "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": 2.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.71
            },
            {
              "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": 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": 2.09
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 3.31,
              "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": 2.09
            },
            {
              "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": 1.84
            },
            {
              "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": 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": 3.31,
              "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": 3.31,
              "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": 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": 2.71
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.42
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 3.31,
              "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": 2.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 2.42
            },
            {
              "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": 3.31,
              "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": 1.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.42
            },
            {
              "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": 2.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.71
            },
            {
              "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": 2.71
            },
            {
              "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": 2.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.31,
              "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": 2.15
            },
            {
              "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": 3.31,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Derma Dry Advance Xlg 58in-63in Attends",
      "code_information": [
        {
          "code": "PX-CHIMCDDA40",
          "type": "CDM"
        },
        {
          "code": "T4524",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.18,
          "discounted_cash": 0.77,
          "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": 0.76
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 0.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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
            },
            {
              "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 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": "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": "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": 0.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.18,
              "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": 0.86
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.97
            },
            {
              "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": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 1.18,
              "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": 1.18,
              "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": 1.18,
              "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": 1.18,
              "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": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.77
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 0.75
            },
            {
              "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
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1
            },
            {
              "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": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.18,
              "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": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 0.76
            },
            {
              "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": "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 PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 0.65
            },
            {
              "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": 0.76
            },
            {
              "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": 1.18,
              "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": 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": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.86
            },
            {
              "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": 1.18,
              "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": 1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.86
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 1.18,
              "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
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 1.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.98
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "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": "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": "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": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 0.76
            },
            {
              "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": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.97
            },
            {
              "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": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 0.97
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 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": 0.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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": 1.18,
              "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": 0.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.18,
              "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
            },
            {
              "payer_name": "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": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.86
            },
            {
              "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": 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": 1.18,
              "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": 1.18,
              "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": 0.65
            },
            {
              "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": 0.98
            }
          ]
        }
      ]
    },
    {
      "description": "Saline Sterile 100cc Irrigation",
      "code_information": [
        {
          "code": "PX-CHKN1022",
          "type": "CDM"
        },
        {
          "code": "A4216",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.74,
          "discounted_cash": 0.48,
          "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": 0.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.48
            },
            {
              "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": 0.2
            },
            {
              "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": 0.74,
              "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": 0.74,
              "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": 0.74,
              "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": 0.74,
              "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": 0.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.41
            },
            {
              "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": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.61
            },
            {
              "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": 0.74,
              "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": 0.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.41
            },
            {
              "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": 0.54
            },
            {
              "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": 0.74,
              "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": 0.61
            },
            {
              "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": 0.74,
              "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": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.61
            },
            {
              "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": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.74,
              "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": 0.63
            },
            {
              "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": 0.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.54
            },
            {
              "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": 0.74,
              "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": 0.74,
              "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": 0.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.74,
              "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": 0.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.61
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.74,
              "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": 0.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.63
            },
            {
              "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": 0.74,
              "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": 0.74,
              "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": 0.74,
              "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": 0.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.54
            },
            {
              "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": 0.48
            },
            {
              "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": 0.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.63
            },
            {
              "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": 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": 0.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.74,
              "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": 0.48
            },
            {
              "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": 0.74,
              "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": 0.48
            },
            {
              "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": 0.74,
              "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": 0.65
            },
            {
              "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": 0.41
            },
            {
              "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": 0.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.63
            },
            {
              "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": 0.74,
              "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": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.47
            },
            {
              "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": 0.61
            },
            {
              "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": 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": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.74,
              "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": 0.74,
              "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": 0.74,
              "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": 0.48
            },
            {
              "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": 0.74,
              "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": 0.74,
              "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": 0.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.56
            },
            {
              "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": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.74,
              "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": 0.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.74,
              "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": 0.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.47
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.41
            },
            {
              "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": 0.74,
              "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": 0.74,
              "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": 0.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.47
            },
            {
              "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": 0.74,
              "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": 0.63
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 1.11,
          "discounted_cash": 0.72,
          "payers_information": [
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.94
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.81
            },
            {
              "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": 0.94
            },
            {
              "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": 0.71
            },
            {
              "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": 1.11,
              "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": 1.11,
              "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": 0.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 0.72
            },
            {
              "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": 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": 0.81
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 1.11,
              "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": 0.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.94
            },
            {
              "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": 0.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.91
            },
            {
              "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": 1.11,
              "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": 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": 0.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.81
            },
            {
              "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": 1.11,
              "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": 1.11,
              "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": 0.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 0.61
            },
            {
              "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": 1.11,
              "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": 0.9
            },
            {
              "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": 1.11,
              "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": 0.7
            },
            {
              "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": 0.71
            },
            {
              "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": 0.97
            },
            {
              "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": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 0.72
            },
            {
              "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": 0.94
            },
            {
              "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": 0.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 1.11,
              "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": 0.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.11,
              "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": 0.94
            },
            {
              "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": 1.11,
              "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": 0.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.91
            },
            {
              "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": 1.11,
              "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": 0.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.61
            },
            {
              "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": 1.11,
              "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": 1.11,
              "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": 0.94
            },
            {
              "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": 0.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 0.92
            },
            {
              "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": 1.11,
              "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": 0.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.94
            },
            {
              "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": 1.11,
              "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": 0.71
            },
            {
              "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": 1.11,
              "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": 0.71
            },
            {
              "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": 0.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.61
            },
            {
              "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": 0.62
            },
            {
              "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": 0.7
            },
            {
              "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": 0.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 1.11,
              "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": 1.11,
              "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": 0.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.71
            },
            {
              "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": 1.11,
              "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": 1.11,
              "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": 1.11,
              "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": 1.11,
              "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": 0.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.11,
              "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": 1.11,
              "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": 1.11,
              "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": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.7
            },
            {
              "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": 0.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.94
            },
            {
              "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": 1.11,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Antimicrobial Ag Drsg Acticoat 4\"\" X 8\"\" Flex 3 Silcryst\"",
      "code_information": [
        {
          "code": "PX-CHUN66800417",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 27.7,
          "discounted_cash": 18,
          "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": 17.78
            },
            {
              "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": 27.7,
              "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": 23.55
            },
            {
              "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": 22.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.24
            },
            {
              "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": 17.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.71
            },
            {
              "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": 17.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 23.55
            },
            {
              "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": 23.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.37
            },
            {
              "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": 22.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 15.24
            },
            {
              "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": 17.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 23.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.55
            },
            {
              "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": 22.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 22.41
            },
            {
              "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": 7.56
            },
            {
              "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": 18.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 24.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 27.7,
              "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": 20.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.78
            },
            {
              "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": 27.7,
              "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": 23.55
            },
            {
              "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": 18.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.24
            },
            {
              "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": 17.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.71
            },
            {
              "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": 15.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.96
            },
            {
              "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": 22.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 15.37
            },
            {
              "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": 24.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.51
            },
            {
              "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": 17.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 27.7,
              "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": 23.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.78
            },
            {
              "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": 24.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 23.55
            },
            {
              "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": 27.7,
              "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": 20.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 22.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.78
            },
            {
              "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": 15.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 27.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 27.7,
              "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": 15.24
            },
            {
              "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": 20.22
            },
            {
              "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": 17.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.24
            },
            {
              "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": 17.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 17.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.7,
              "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": 27.7,
              "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": 17.51
            },
            {
              "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": 15.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC T Cells Total Count So",
      "code_information": [
        {
          "code": "PX-30200643",
          "type": "CDM"
        },
        {
          "code": "86359",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 51,
          "discounted_cash": 33.15,
          "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": 32.74
            },
            {
              "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": 28.31
            },
            {
              "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": 44.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 43.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.62,
              "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": 32.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.62,
              "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": 33.2
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 28.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 51,
              "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": 43.35
            },
            {
              "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": 51,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.12,
              "estimated_amount": 55.12
            },
            {
              "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": 32.74
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "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": 41.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 44.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "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": 33.15
            },
            {
              "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": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.92
            },
            {
              "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": 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": 37.23
            },
            {
              "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": 28.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 32.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "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": 42.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.2
            },
            {
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "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": 32.74
            },
            {
              "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": 41.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.26
            },
            {
              "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": 33.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 37.23
            },
            {
              "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": 51,
              "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": 32.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.25
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "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": 28.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "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": 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": "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 SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 44.88
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.12,
              "estimated_amount": 55.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "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": 41.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "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": "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": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "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": 32.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 28.05
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.12,
              "estimated_amount": 55.12
            },
            {
              "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": 33.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 32.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            }
          ],
          "minimum": 37.73,
          "maximum": 141.49
        }
      ]
    },
    {
      "description": "HC Replacement of G-Tube Tube Perc WO Img No Revision",
      "code_information": [
        {
          "code": "PX-75000172",
          "type": "CDM"
        },
        {
          "code": "43762",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2561,
          "discounted_cash": 1664.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "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": 217.86,
              "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": 2246
            },
            {
              "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": 215.71,
              "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": 73.2,
              "estimated_amount": 1874.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2123.07
            },
            {
              "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": 2561,
              "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": 1869.53
            },
            {
              "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": 1667.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1920.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 2100.02
            },
            {
              "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": 215.71,
              "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": 2561,
              "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": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1408.55
            },
            {
              "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": 217.86,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2071.85
            },
            {
              "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": 1874.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "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": 1664.65
            },
            {
              "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": 1882.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "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": 220.11,
              "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": 1869.53
            },
            {
              "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": 2100.02
            },
            {
              "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": 699.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 2123.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1874.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1408.55
            },
            {
              "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": 1884.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1869.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 2561,
              "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": 2176.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1882.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1920.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1869.53
            },
            {
              "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": 215.71,
              "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": 2561,
              "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": 2071.85
            },
            {
              "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": 1869.53
            },
            {
              "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": 2561,
              "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": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2100.02
            },
            {
              "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": 217.86,
              "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": 217.86,
              "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": 1667.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2561
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 2561,
              "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": 2123.07
            },
            {
              "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": 226.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1874.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 2561,
              "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": 2561,
              "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": 1667.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "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": 1882.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1920.75
            },
            {
              "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": 2561,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1874.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1408.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1408.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1667.21
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.71,
              "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": 2100.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 2561,
              "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": 560.86
            },
            {
              "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": 2176.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "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": 1874.65
            },
            {
              "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": 2176.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 2561,
              "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": 2176.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1667.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2561,
              "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": 215.71,
              "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": 1874.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2100.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1408.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2100.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1408.55
            },
            {
              "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": 2253.68
            },
            {
              "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": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "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": 226.49,
              "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": 220.11,
              "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": 220.11,
              "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": 215.71,
              "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": 1869.53
            },
            {
              "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": 2246
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "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": 2561,
              "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": 73.6,
              "estimated_amount": 1884.9
            },
            {
              "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": 1882.34
            },
            {
              "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": 1408.55
            },
            {
              "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": 2100.02
            },
            {
              "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": 1874.65
            },
            {
              "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": 226.49,
              "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": 2561,
              "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": 2561,
              "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": 217.86,
              "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": 2100.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2176.85
            },
            {
              "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": 1884.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fine Needle Asp Biopsy W Ultrasound 1st Lesion",
      "code_information": [
        {
          "code": "PX-36100958",
          "type": "CDM"
        },
        {
          "code": "10005",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5126,
          "discounted_cash": 3331.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3290.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3290.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4203.32
            },
            {
              "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": 3331.9
            },
            {
              "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": 4357.1
            },
            {
              "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": 3290.89
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 614.07,
              "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": 4249.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3239.63
            },
            {
              "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": 5126,
              "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": 620.21,
              "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": 620.21,
              "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": 3290.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3337.03
            },
            {
              "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": 4203.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3290.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4203.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3290.89
            },
            {
              "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": 3239.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 5126,
              "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": 1399.4
            },
            {
              "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": 614.07,
              "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": 4357.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2819.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3741.98
            },
            {
              "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": 5126,
              "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": 5126,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            },
            {
              "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": 2819.3
            },
            {
              "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": 644.77,
              "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": 4146.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3337.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4203.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4203.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3290.89
            },
            {
              "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": 644.77,
              "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": 5126,
              "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": 4357.1
            },
            {
              "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": 620.21,
              "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": 5126,
              "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": 3741.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 3290.89
            },
            {
              "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": 3290.89
            },
            {
              "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": 1122.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3290.89
            },
            {
              "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": 3337.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 644.77,
              "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": 3844.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 4357.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2819.3
            },
            {
              "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": 614.07,
              "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": 614.07,
              "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": 4249.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 5126,
              "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": 4203.32
            },
            {
              "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": 3337.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3844.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3741.98
            },
            {
              "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": 3741.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2819.3
            },
            {
              "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": 626.6,
              "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": 3290.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4203.32
            },
            {
              "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": 3239.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 4357.1
            },
            {
              "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": 4495.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            },
            {
              "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": 3290.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2819.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3741.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3741.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5126,
              "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": 4495.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3239.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5126,
              "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": 5126,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3239.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2819.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2819.3
            },
            {
              "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": 5126,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "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": 4249.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3844.5
            },
            {
              "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": 626.6,
              "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": 3239.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 4146.93
            },
            {
              "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": 4357.1
            },
            {
              "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": 3239.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5126,
              "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": 5126,
              "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": 5126,
              "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": 5126,
              "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": 626.6,
              "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": 4510.88
            },
            {
              "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": 4203.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3239.63
            },
            {
              "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": 620.21,
              "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": 620.21,
              "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": 3337.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4357.1
            }
          ]
        }
      ]
    },
    {
      "description": "Everolimus Sendout",
      "code_information": [
        {
          "code": "PX-30101001",
          "type": "CDM"
        },
        {
          "code": "80169",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 92,
          "discounted_cash": 59.8,
          "payers_information": [
            {
              "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": 57.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "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": 45,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": 78.2
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "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": 23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.39,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "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": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.39,
              "estimated_amount": 19.39
            },
            {
              "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": 57.5
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": 75.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 41.4
            },
            {
              "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": 46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "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": 57.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.42,
              "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": 78.2
            },
            {
              "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": 41.4
            },
            {
              "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": 41.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "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": 75.44
            },
            {
              "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 CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": 92,
              "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": 67.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 41.4
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "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": 45,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "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": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": 59.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "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": 75.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.39,
              "estimated_amount": 19.39
            },
            {
              "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": "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": 57.5
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 78.2
            },
            {
              "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": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "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": 50.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 57.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            }
          ],
          "minimum": 11.78,
          "maximum": 51.49
        }
      ]
    },
    {
      "description": "HC MRI Brain During Open Proc WO Cont",
      "code_information": [
        {
          "code": "PX-61100009",
          "type": "CDM"
        },
        {
          "code": "70557",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2647,
          "discounted_cash": 1720.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1937.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 2249.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2249.95
            },
            {
              "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": 2249.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2249.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2249.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 73.2,
              "estimated_amount": 1937.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 2249.95
            },
            {
              "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": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1723.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 2249.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1932.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1985.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1455.85
            },
            {
              "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": 1945.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2647,
              "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": 2647,
              "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": 2647,
              "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": 1723.2
            },
            {
              "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": 1948.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 1455.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "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": 2249.95
            },
            {
              "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": 1932.31
            },
            {
              "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": 1945.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2194.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2141.42
            },
            {
              "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": 1945.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1937.6
            },
            {
              "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": 1720.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1932.31
            },
            {
              "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": 1948.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1985.25
            },
            {
              "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": 2321.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 2647,
              "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": 2170.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2249.95
            },
            {
              "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": 1937.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1937.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2249.95
            },
            {
              "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": 2321.42
            },
            {
              "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": 2647,
              "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": 2647,
              "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": 2329.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "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": 1723.2
            },
            {
              "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": 1948.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "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": 1937.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1937.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 2647,
              "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": 2647,
              "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": 1455.85
            },
            {
              "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": 2647,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1723.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2170.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1945.55
            },
            {
              "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": 2194.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1455.85
            },
            {
              "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": 2170.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2170.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2249.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 2647,
              "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": 1932.31
            },
            {
              "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": 1937.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1985.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2170.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "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": 2141.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1932.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2249.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1455.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1948.19
            },
            {
              "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": 2170.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1455.85
            },
            {
              "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": 2647,
              "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": 2647,
              "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": 2647,
              "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": 2194.36
            },
            {
              "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": 1948.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2647
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2170.54
            },
            {
              "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": 2170.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2647,
              "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": 722.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1455.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1932.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1723.2
            }
          ]
        }
      ]
    },
    {
      "description": "Suction Tubing Blue Tip 16\"\"",
      "code_information": [
        {
          "code": "PX-CHFHAG615473",
          "type": "CDM"
        },
        {
          "code": "A7002",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.66,
          "discounted_cash": 1.73,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.71
            },
            {
              "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": 1.71
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 1.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 1.68
            },
            {
              "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": 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": 2.66,
              "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": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 2.15
            },
            {
              "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": 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": 1.71
            },
            {
              "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": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 2.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.26
            },
            {
              "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": 1.48
            },
            {
              "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": 1.71
            },
            {
              "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": 2.15
            },
            {
              "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": "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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 2.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 2.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 1.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.26
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 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": 2.34
            },
            {
              "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": 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": 1.68
            },
            {
              "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.66,
              "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": 2.66,
              "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": 2.66,
              "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": 2.66,
              "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": 2.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.18
            },
            {
              "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": 1.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 1.71
            },
            {
              "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": 2.21
            },
            {
              "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": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.71
            },
            {
              "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": 2.66,
              "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": 2.66,
              "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": 2.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.48
            },
            {
              "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": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 1.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 2.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.66,
              "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": 2.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.21
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.21
            },
            {
              "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": 1.68
            },
            {
              "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": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "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": 2.66,
              "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": 1.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 2.66
            },
            {
              "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": 1.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.94
            },
            {
              "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": 2.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 1.46
            },
            {
              "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": 2.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.66,
              "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": 1.71
            },
            {
              "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": 2.18
            }
          ]
        }
      ]
    },
    {
      "description": "Plug Catheter With Cap Single Use Latex-Free",
      "code_information": [
        {
          "code": "PX-CHBA000076",
          "type": "CDM"
        },
        {
          "code": "A4335",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.96,
          "discounted_cash": 0.62,
          "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": 0.62
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.96,
              "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": 0.79
            },
            {
              "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": 0.96,
              "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": 0.7
            },
            {
              "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": 0.84
            },
            {
              "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": 0.96,
              "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": 0.82
            },
            {
              "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": 0.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.61
            },
            {
              "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": 0.96,
              "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": 0.62
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.79
            },
            {
              "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": 0.61
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.96,
              "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": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.79
            },
            {
              "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": 0.61
            },
            {
              "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": 0.96,
              "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": 0.72
            },
            {
              "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": 0.96,
              "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": 0.96,
              "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": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.62
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.72
            },
            {
              "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": 0.96,
              "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": 0.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "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": 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": 0.7
            },
            {
              "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": 0.96,
              "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": 0.96,
              "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": 0.96,
              "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": 0.96,
              "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": 0.62
            },
            {
              "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": 0.96,
              "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": 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": 0.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.96,
              "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": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.96,
              "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": 0.96,
              "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": 0.62
            },
            {
              "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": 0.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.53
            },
            {
              "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": 0.96,
              "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": 0.53
            },
            {
              "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": 0.96,
              "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": 0.96,
              "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": 0.96,
              "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": 0.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.96,
              "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": 0.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.53
            },
            {
              "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": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "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": 0.96,
              "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": 0.96,
              "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": 0.82
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.8
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.62
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.62
            },
            {
              "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": 0.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.96,
              "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": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "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": 0.96,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Petroleum Jelly Vaseline 1 Oz White",
      "code_information": [
        {
          "code": "PX-CHKN430200",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.69,
          "discounted_cash": 0.45,
          "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": 0.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "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": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.69,
              "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": 0.44
            },
            {
              "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": 0.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.38
            },
            {
              "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": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.57
            },
            {
              "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": 0.45
            },
            {
              "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": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.44
            },
            {
              "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": 0.69,
              "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": 0.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.52
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.5
            },
            {
              "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": 0.69,
              "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": 0.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 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": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 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": 0.69,
              "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": 0.69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 0.69,
              "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": 0.5
            },
            {
              "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": 0.69,
              "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": 0.69,
              "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": 0.38
            },
            {
              "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": 0.69,
              "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": 0.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.5
            },
            {
              "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": 0.69,
              "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": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.44
            },
            {
              "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": 0.61
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.69,
              "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": 0.69,
              "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": 0.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.52
            },
            {
              "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": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.45
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.44
            },
            {
              "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": 0.19
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.59
            },
            {
              "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": 0.44
            },
            {
              "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": 0.69,
              "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": 0.69,
              "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": 0.69,
              "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": 0.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.69,
              "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": 0.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Intraprocedural Coronary Ffr Values for Stenosis Interven Add On",
      "code_information": [
        {
          "code": "PX-36100964",
          "type": "CDM"
        },
        {
          "code": "0523T",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 476,
          "discounted_cash": 309.4,
          "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": 305.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 261.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 309.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 390.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 476,
              "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": 476,
              "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": 476,
              "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": 305.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 305.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 300.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 476,
              "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": 476,
              "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": 300.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 347.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 357
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 264.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 357
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 305.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 305.59
            },
            {
              "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": 309.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 300.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 261.8
            },
            {
              "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": 394.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 390.32
            },
            {
              "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": 404.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 347.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 305.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 305.59
            },
            {
              "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": 264.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 261.8
            },
            {
              "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": 305.59
            },
            {
              "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": 264.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 300.83
            },
            {
              "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": 417.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 476,
              "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": 261.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 347.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 300.83
            },
            {
              "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": 418.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "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": 417.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 309.88
            },
            {
              "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": 300.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 305.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 261.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 385.08
            },
            {
              "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": 390.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 404.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 264.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 305.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 390.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 390.32
            },
            {
              "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": 390.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 394.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 261.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 347.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 300.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 305.59
            },
            {
              "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": 300.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 476,
              "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": 309.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 394.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 357
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 404.6
            },
            {
              "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": 305.59
            },
            {
              "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": 129.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 261.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 347.48
            },
            {
              "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": 347.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 404.6
            },
            {
              "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": 385.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 309.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 476,
              "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": 404.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 390.32
            },
            {
              "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": 390.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 476
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 309.88
            }
          ]
        }
      ]
    },
    {
      "description": "\"Hernia Belt Flat Panel 2-3-8\"\" Opening 4\"\" W 36 to 40\"\"\"",
      "code_information": [
        {
          "code": "PX-CHNH2662",
          "type": "CDM"
        },
        {
          "code": "A4396",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 65.34,
          "discounted_cash": 42.47,
          "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": 41.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.29
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.54
            },
            {
              "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": 65.34,
              "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": 65.34,
              "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": 65.34,
              "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": 41.95
            },
            {
              "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": 65.34,
              "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": 55.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.58
            },
            {
              "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": 57.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 47.7
            },
            {
              "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": 65.34,
              "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": 36.26
            },
            {
              "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": 36.26
            },
            {
              "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": 42.54
            },
            {
              "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": 17.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 55.54
            },
            {
              "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": 41.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 65.34,
              "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": 47.7
            },
            {
              "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": 42.47
            },
            {
              "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": 55.54
            },
            {
              "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": 55.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 49.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 41.95
            },
            {
              "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": 41.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.34,
              "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": 41.95
            },
            {
              "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": 52.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.94
            },
            {
              "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": 35.94
            },
            {
              "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": 53.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 49.01
            },
            {
              "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": 53.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 65.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.94
            },
            {
              "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": 47.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 41.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 35.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.58
            },
            {
              "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": 36.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.94
            },
            {
              "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": 57.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 41.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.7
            },
            {
              "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": 54.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.94
            },
            {
              "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": 41.29
            },
            {
              "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": 42.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 65.34,
              "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": 65.34,
              "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": 65.34,
              "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": 55.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.95
            },
            {
              "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": 57.3
            },
            {
              "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": 53.58
            },
            {
              "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": 41.29
            },
            {
              "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": 41.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 55.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.34,
              "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": 65.34,
              "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": 49.01
            }
          ]
        }
      ]
    },
    {
      "description": "Trach Inner Cannula Disposable Size 6 Cuffless Shiley",
      "code_information": [
        {
          "code": "PX-CH2M6DCFS",
          "type": "CDM"
        },
        {
          "code": "A7520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 71.6,
          "discounted_cash": 46.54,
          "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": 45.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "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": 71.6,
              "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": 71.6,
              "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": 71.6,
              "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": 63.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "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": "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": 71.6,
              "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": 52.27
            },
            {
              "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": 62.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 71.6
            },
            {
              "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": 19.55
            },
            {
              "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": 71.6,
              "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": 60.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "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": "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": 60.86
            },
            {
              "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": "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": 60.86
            },
            {
              "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": 58.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "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": "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": 71.6,
              "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": 39.38
            },
            {
              "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": "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": 59.36
            },
            {
              "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": "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": 71.6,
              "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": 45.97
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "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": "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": "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": 45.97
            },
            {
              "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": 58.71
            },
            {
              "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": 71.6,
              "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": 62.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.36
            },
            {
              "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": 45.25
            },
            {
              "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": "AETNA [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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "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": "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/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "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": 71.6,
              "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": 52.27
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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": "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": "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": "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": "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": 71.6,
              "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": 71.6,
              "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": 59.36
            },
            {
              "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": 58.71
            },
            {
              "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": 71.6,
              "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": 39.38
            },
            {
              "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": 71.6,
              "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": 45.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "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": 71.6,
              "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": 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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 39.74
            },
            {
              "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": 71.6,
              "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": 39.74
            },
            {
              "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": "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": 71.6,
              "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": 53.7
            },
            {
              "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": 45.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "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": "LAB FEE SCHEDULE"
            },
            {
              "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": "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": "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": "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": "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": 39.74
            },
            {
              "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": 45.97
            },
            {
              "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": 57.92
            },
            {
              "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": 52.27
            },
            {
              "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": 45.97
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.61
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "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": "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": 71.6,
              "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": 57.92
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.74
            },
            {
              "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": 46.61
            },
            {
              "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": "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": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter External All Silicone Large 36mm Standard Wear",
      "code_information": [
        {
          "code": "PX-CHHO97536",
          "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.71
            },
            {
              "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": 1.71,
              "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": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.25
            },
            {
              "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": 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": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "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 FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.95
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "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": 0.47
            },
            {
              "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": 1.1
            },
            {
              "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": 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": 1.4
            },
            {
              "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.28
            },
            {
              "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": 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "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/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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "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": 1.71,
              "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": 1.71,
              "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": 1.45
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.28
            },
            {
              "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": "HUMANA [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": "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": "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": "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": "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 GEHA [625285]",
              "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 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": "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "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": 1.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.4
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.11
            },
            {
              "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.94
            },
            {
              "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": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.71,
              "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": 0.94
            },
            {
              "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": "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": "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": "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": "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 HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.71,
              "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": 1.4
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Strip Elastic Brava C-Shaped X-Lrg Strip",
      "code_information": [
        {
          "code": "PX-CHCO120761",
          "type": "CDM"
        },
        {
          "code": "A5121",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.6,
          "discounted_cash": 2.34,
          "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": 2.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.34
            },
            {
              "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": 2.63
            },
            {
              "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": 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": 2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "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": 2.95
            },
            {
              "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": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 2.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 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": 0.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 2.95
            },
            {
              "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": 3.6,
              "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": 3.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "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": 2.28
            },
            {
              "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": 3.6,
              "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": 2.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 3.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6
            },
            {
              "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": 3.6,
              "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": 2.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 2.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 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": 2.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 2.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.7
            },
            {
              "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": 2.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.06
            },
            {
              "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": 3.6,
              "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": 2.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 2.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "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": 3.6,
              "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": 1.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "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": 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": 2.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.98
            },
            {
              "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": 2.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "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": 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": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "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": 2.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "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": 1.98
            },
            {
              "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": 3.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            }
          ]
        }
      ]
    },
    {
      "description": "Skin Closure Steristrip 3mm X 75mm",
      "code_information": [
        {
          "code": "PX-CH3MR1540",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.71,
          "discounted_cash": 1.11,
          "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": 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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.71,
              "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": 1.25
            },
            {
              "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": 1.71,
              "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": 1.25
            },
            {
              "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": 1.71,
              "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": 1.71,
              "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": 1.71,
              "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": 1.45
            },
            {
              "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": 1.71,
              "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": 1.71,
              "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": 1.1
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.71,
              "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": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "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": 1.71,
              "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": 1.25
            },
            {
              "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": 1.71,
              "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": 1.71,
              "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": 1.71,
              "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": 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": 1.08
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.71,
              "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": 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": "AETNA [310]",
              "plan_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": "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 OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.11
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "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": 1.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "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": 1.71,
              "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": 1.08
            },
            {
              "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 1.71,
              "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": 1.28
            },
            {
              "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": 1.71,
              "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": 1.08
            },
            {
              "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": "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": 1.71,
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "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": 0.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.71,
              "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": 1.71,
              "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": 1.71,
              "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": 1.45
            },
            {
              "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": 1.42
            },
            {
              "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": 1.71,
              "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": 1.45
            },
            {
              "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.71,
              "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": 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": 1.25
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "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": "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "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": 1.5
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.71,
              "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": 1.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "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": "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": "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": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "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": 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": 1.42
            }
          ]
        }
      ]
    },
    {
      "description": "HC Allograft 12mm Disc Floweraminopatch",
      "code_information": [
        {
          "code": "PX-27200504",
          "type": "CDM"
        },
        {
          "code": "Q4178",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1999,
          "discounted_cash": 1299.35,
          "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": 1283.36
            },
            {
              "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": 1283.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1459.27
            },
            {
              "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": 1263.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1263.37
            },
            {
              "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": 1753.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1999,
              "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": 1999,
              "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": 1999,
              "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": 1699.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1099.45
            },
            {
              "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": 1301.35
            },
            {
              "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": 1639.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1099.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1699.15
            },
            {
              "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": 1999,
              "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": 1639.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1639.18
            },
            {
              "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": 1999,
              "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": 1499.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1283.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1283.36
            },
            {
              "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": 1639.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1263.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1699.15
            },
            {
              "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": 1109.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1459.27
            },
            {
              "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": 1999,
              "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": 1657.17
            },
            {
              "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": 1263.37
            },
            {
              "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": 1999,
              "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": 1999,
              "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": 1639.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1617.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1109.45
            },
            {
              "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": 1109.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1999,
              "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": 1699.15
            },
            {
              "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": 437.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1499.25
            },
            {
              "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": 1299.35
            },
            {
              "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": 1283.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1283.36
            },
            {
              "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": 1999,
              "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": 1999,
              "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": 1499.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1699.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1283.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1283.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1459.27
            },
            {
              "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": 1999,
              "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": 1099.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1459.27
            },
            {
              "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": 1999,
              "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": 1283.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1999,
              "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": 545.73
            },
            {
              "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": 1099.45
            },
            {
              "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": 1283.36
            },
            {
              "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": 1301.35
            },
            {
              "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": 1459.27
            },
            {
              "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": 1999,
              "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": 1699.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1099.45
            },
            {
              "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": 1999,
              "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": 1999
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1263.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1999,
              "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": 1999,
              "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": 1759.12
            },
            {
              "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": 1999,
              "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": 1999,
              "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": 1999,
              "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": 1699.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1283.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1301.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1639.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1639.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1699.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1459.27
            },
            {
              "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": 1657.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1301.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1639.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1099.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1301.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1699.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1657.17
            },
            {
              "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": 1263.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1617.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1263.37
            },
            {
              "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": 1753.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1699.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1999,
              "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": 1999,
              "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": 1699.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1099.45
            },
            {
              "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": 1999,
              "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": 1999,
              "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": 1699.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1699.15
            },
            {
              "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": 1109.45
            },
            {
              "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": 1999,
              "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": 1283.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1263.37
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1999,
              "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": 1699.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC Desflurane per 15 Minutes",
      "code_information": [
        {
          "code": "PX-25000050",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29,
          "discounted_cash": 18.85,
          "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": 18.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "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": 18.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "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": 18.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "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": 18.62
            },
            {
              "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": 18.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 23.46
            },
            {
              "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": 18.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29,
              "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": 18.21
            },
            {
              "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": 29,
              "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": 21.17
            },
            {
              "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": 24.65
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.75
            },
            {
              "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": 21.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "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": 18.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "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": 16.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "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": 29,
              "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": 24.65
            },
            {
              "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": 18.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "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": 29,
              "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": 23.78
            },
            {
              "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": 25.43
            },
            {
              "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": 23.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.82
            },
            {
              "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": 24.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "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": 7.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 24.04
            },
            {
              "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": 29,
              "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": 18.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 24.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.75
            },
            {
              "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": 25.43
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 18.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "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": 18.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "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": 16.1
            },
            {
              "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": 15.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "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": 18.62
            },
            {
              "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": 16.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 18.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 25.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "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": 18.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "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": 18.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC Protein Electrophoresis Body Fluid So",
      "code_information": [
        {
          "code": "PX-30101049",
          "type": "CDM"
        },
        {
          "code": "84166",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 185,
          "discounted_cash": 120.25,
          "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": 118.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.83,
              "estimated_amount": 17.83
            },
            {
              "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": "AETNA [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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.83,
              "estimated_amount": 17.83
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.01,
              "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": 185,
              "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": 120.44
            },
            {
              "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": 135.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.83,
              "estimated_amount": 17.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.01,
              "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": 102.68
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "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": 162.8
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.83,
              "estimated_amount": 17.83
            },
            {
              "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": 118.77
            },
            {
              "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": 120.44
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.72,
              "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": 185
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.83,
              "estimated_amount": 17.83
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.78,
              "estimated_amount": 19.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "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": 157.25
            },
            {
              "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.78,
              "estimated_amount": 19.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "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": 185,
              "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": 149.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "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": 118.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "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": 185,
              "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": 101.75
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.83,
              "estimated_amount": 17.83
            },
            {
              "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": "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": "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "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": 162.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "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": 116.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "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": 120.25
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.78,
              "estimated_amount": 19.78
            },
            {
              "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": 116.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.01,
              "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": 149.67
            },
            {
              "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": 118.77
            },
            {
              "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": "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": "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": "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.01,
              "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": 116.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.86,
              "estimated_amount": 66.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.72,
              "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": 102.68
            },
            {
              "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": "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "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": 118.77
            },
            {
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.01,
              "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": 118.77
            },
            {
              "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": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 17.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.83,
              "estimated_amount": 17.83
            },
            {
              "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": 153.37
            }
          ],
          "minimum": 17.83,
          "maximum": 66.86
        }
      ]
    },
    {
      "description": "Ide G140056 Pro 1149152",
      "code_information": [
        {
          "code": "PX-62400128",
          "type": "CDM"
        },
        {
          "code": "C1889",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6500,
          "discounted_cash": 4225,
          "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": 4173
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 4745
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4108
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 6500,
              "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": 6500,
              "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": 1423.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5525
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 5525
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4745
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4108
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3575
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6500,
              "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": 4173
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4108
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5700.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 6500,
              "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": 6500,
              "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": 5525
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 5525
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3607.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 5525
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5525
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5330
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5525
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5330
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3575
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5525
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3575
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 6500,
              "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": 6500,
              "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": 6500,
              "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": 6500,
              "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": 5525
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5525
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5330
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4108
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4108
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4745
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 6500,
              "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": 6500,
              "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": 6500,
              "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": 6500,
              "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": 6500,
              "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": 5388.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4745
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4108
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4231.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3607.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4745
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5525
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4231.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5330
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1774.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6500
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5388.5
            },
            {
              "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": 5700.5
            },
            {
              "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": 5720
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3607.5
            },
            {
              "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": 3607.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 4108
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6500,
              "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": 4745
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 5525
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4173
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4231.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3575
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3575
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5525
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 6500,
              "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": 4108
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 6500,
              "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": 6500,
              "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": 5258.5
            },
            {
              "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": 4231.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4231.5
            },
            {
              "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": 5258.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5388.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3575
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6500,
              "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": 4173
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 4875
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 4875
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4225
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 5525
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5330
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 4173
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5330
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6500,
              "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": 5330
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5330
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6500,
              "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": 4875
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3575
            }
          ]
        }
      ]
    },
    {
      "description": "HH Ot Ultrasound",
      "code_information": [
        {
          "code": "PX-43100104",
          "type": "CDM"
        },
        {
          "code": "97035",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 60.5,
          "discounted_cash": 39.32,
          "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": 38.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 33.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 13.4
            },
            {
              "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": 39.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 50.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 16.52
            },
            {
              "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": 14.07
            },
            {
              "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": 60.5,
              "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": 39.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 49.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 51.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.58
            },
            {
              "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": 51.43
            },
            {
              "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": 13.4
            },
            {
              "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": 33.58
            },
            {
              "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": 49.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 60.5,
              "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": 45.38
            },
            {
              "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": 38.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 44.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 38.24
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 33.28
            },
            {
              "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": 13.4
            },
            {
              "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": 53.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 39.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 60.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "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": 60.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 12.64
            },
            {
              "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": 38.84
            },
            {
              "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": 60.5,
              "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": 48.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "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": 53.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 50.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 33.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 44.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 38.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 13.4
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 38.24
            },
            {
              "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": 13.4
            },
            {
              "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": 60.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "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": 51.43
            },
            {
              "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": 38.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 60.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 53.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 38.84
            },
            {
              "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": 39.39
            },
            {
              "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": 49.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 60.5,
              "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": 38.84
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 33.28
            },
            {
              "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": 38.84
            },
            {
              "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": 48.94
            }
          ]
        }
      ]
    },
    {
      "description": "HH Ot Therapy Procedure One or More Area",
      "code_information": [
        {
          "code": "PX-43100106",
          "type": "CDM"
        },
        {
          "code": "97110",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 60.5,
          "discounted_cash": 39.32,
          "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": 38.84
            },
            {
              "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": 38.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "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": 38.24
            },
            {
              "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": 60.5,
              "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": 60.5,
              "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": 60.5,
              "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": 45.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 51.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "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": 39.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 60.5,
              "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": 51.43
            },
            {
              "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": 33.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 28.06
            },
            {
              "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": 38.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 48.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 53.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 33.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "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": 44.17
            },
            {
              "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": 49.61
            },
            {
              "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": 29.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.38
            },
            {
              "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": 60.5,
              "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": 33.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 38.84
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "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": 60.5,
              "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": 53.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 53.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 51.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 60.5,
              "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": 38.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 49.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "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": 28.06
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.15
            },
            {
              "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": 49.61
            },
            {
              "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": 51.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 39.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "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": 33.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 60.5,
              "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": 38.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 44.17
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 16.52
            },
            {
              "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": 28.06
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 60.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 38.84
            },
            {
              "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": 38.24
            },
            {
              "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": 60.5,
              "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": 60.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 32.01
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 38.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "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": 48.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 44.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 50.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.38
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "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": 60.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 39.39
            }
          ]
        }
      ]
    },
    {
      "description": "HC Imrt Simple Incl Image Guidance",
      "code_information": [
        {
          "code": "PX-33300059",
          "type": "CDM"
        },
        {
          "code": "77385",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4042,
          "discounted_cash": 2627.3,
          "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": 2594.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3314.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2950.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3031.5
            },
            {
              "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": 518.91,
              "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": 3435.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "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": 3556.96
            },
            {
              "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": 2243.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4042,
              "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": 2631.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2223.1
            },
            {
              "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": 513.77,
              "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": 3350.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4042,
              "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": 2594.96
            },
            {
              "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": 3314.44
            },
            {
              "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": 524.26,
              "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": 2243.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3031.5
            },
            {
              "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": 2950.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2631.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2594.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2554.54
            },
            {
              "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": 518.91,
              "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": 2594.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3314.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4042,
              "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": 4042,
              "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": 3435.7
            },
            {
              "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": 518.91,
              "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": 539.46,
              "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": 3435.7
            },
            {
              "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": 2243.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4042,
              "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": 4042,
              "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": 4042,
              "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": 1103.47
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 539.46,
              "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": 2554.54
            },
            {
              "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": 539.46,
              "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": 63.2,
              "estimated_amount": 2554.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2554.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2950.66
            },
            {
              "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": 4042,
              "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": 2554.54
            },
            {
              "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": 3314.44
            },
            {
              "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": 513.77,
              "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": 2950.66
            },
            {
              "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": 4042,
              "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": 2627.3
            },
            {
              "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": 4042,
              "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": 2554.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2950.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2594.96
            },
            {
              "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": 2631.34
            },
            {
              "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": 513.77,
              "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": 4042,
              "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": 3435.7
            },
            {
              "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": 513.77,
              "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": 3350.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2223.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2223.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2950.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2594.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2631.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3314.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3350.82
            },
            {
              "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": 3314.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3031.5
            },
            {
              "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": 4042,
              "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": 4042,
              "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": 4042,
              "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": 4042,
              "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": 4042,
              "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": 3314.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2554.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2223.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4042
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4042,
              "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": 4042,
              "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": 2594.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2594.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2594.96
            },
            {
              "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": 518.91,
              "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": 2223.1
            },
            {
              "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": 3544.83
            },
            {
              "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": 2594.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3314.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2243.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4042,
              "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": 2554.54
            },
            {
              "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": 524.26,
              "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": 885.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "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": 2594.96
            },
            {
              "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": 2631.34
            },
            {
              "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": 3269.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4042,
              "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": 2223.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2223.1
            },
            {
              "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": 3544.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4042,
              "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": 4042,
              "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": 3269.98
            },
            {
              "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": 524.26,
              "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": 518.91,
              "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": 2594.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3435.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC Radiation Trtmnt Delivery Intermed",
      "code_information": [
        {
          "code": "PX-33300063",
          "type": "CDM"
        },
        {
          "code": "77407",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1862,
          "discounted_cash": 1210.3,
          "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": 1195.4
            },
            {
              "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": 1212.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1506.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "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": 1033.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1543.6
            },
            {
              "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": 1862,
              "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": 1862,
              "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": 1862,
              "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": 1862,
              "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": 1176.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1526.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1195.4
            },
            {
              "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": 234.56,
              "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": 1176.78
            },
            {
              "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": 508.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "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": 1862,
              "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": 1543.6
            },
            {
              "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": 246.29,
              "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": 1526.84
            },
            {
              "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": 1632.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.1
            },
            {
              "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": 234.56,
              "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": 1024.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1396.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "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": 1195.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1862
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1195.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.1
            },
            {
              "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": 1212.16
            },
            {
              "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": 239.35,
              "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": 1638.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1195.4
            },
            {
              "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": 1033.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1862,
              "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": 1526.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1359.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 236.9,
              "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": 1862,
              "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": 1862,
              "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": 1176.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1176.78
            },
            {
              "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": 1506.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1632.97
            },
            {
              "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": 1176.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "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": 236.9,
              "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": 1396.5
            },
            {
              "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": 246.29,
              "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": 1359.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.16
            },
            {
              "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": 239.35,
              "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": 407.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1526.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1862,
              "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": 1195.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.16
            },
            {
              "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": 1526.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1582.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.1
            },
            {
              "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": 236.9,
              "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": 1582.7
            },
            {
              "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": 234.56,
              "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": 1359.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1359.26
            },
            {
              "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": 246.29,
              "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": 1582.7
            },
            {
              "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": 239.35,
              "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": 1862,
              "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": 1195.4
            },
            {
              "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": 1195.4
            },
            {
              "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": 236.9,
              "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": 1033.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1176.78
            },
            {
              "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": 1176.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1033.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1862,
              "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": 1024.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1359.26
            },
            {
              "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": 1582.7
            },
            {
              "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": 234.56,
              "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": 1195.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1862,
              "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": 1543.6
            },
            {
              "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": 1526.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1359.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1176.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1195.4
            },
            {
              "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": 1195.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1195.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1396.5
            },
            {
              "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": 236.9,
              "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": 1526.84
            },
            {
              "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": 1210.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.1
            },
            {
              "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": 1862,
              "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": 1862,
              "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": 1862,
              "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": 1526.84
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sigmoidoscopy Flx Ablation Tumor or Lesion",
      "code_information": [
        {
          "code": "PX-75000156",
          "type": "CDM"
        },
        {
          "code": "45346",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5666,
          "discounted_cash": 3682.9,
          "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": 3637.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3116.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3580.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3580.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3580.91
            },
            {
              "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": 3637.57
            },
            {
              "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": 4646.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3116.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4136.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4646.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "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": 5666,
              "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": 4816.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3688.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3637.57
            },
            {
              "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": 3688.57
            },
            {
              "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": 3580.91
            },
            {
              "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": 4816.1
            },
            {
              "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": 5666,
              "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": 4136.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4249.5
            },
            {
              "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": 1240.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5666,
              "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": 3116.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "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": 4646.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5666,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3637.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "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": 5666,
              "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": 4816.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4646.12
            },
            {
              "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": 3580.91
            },
            {
              "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": 4136.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4583.79
            },
            {
              "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": 3116.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5666,
              "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": 3116.3
            },
            {
              "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": 4646.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3688.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5666,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4697.11
            },
            {
              "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": 4816.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "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": 3637.57
            },
            {
              "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": 1546.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4136.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4697.11
            },
            {
              "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": 5666,
              "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": 3580.91
            },
            {
              "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": 4697.11
            },
            {
              "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": 3580.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3750.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4249.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4136.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "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": 4986.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5666,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "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": 3688.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4646.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3637.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3637.57
            },
            {
              "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": 4583.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4646.12
            },
            {
              "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": 3682.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3580.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3688.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3116.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3116.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3637.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4646.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "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": 4969.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4249.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5666,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3620.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3750.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3637.57
            },
            {
              "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": 3637.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3750.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4136.18
            },
            {
              "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": 3637.57
            },
            {
              "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": 4969.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3750.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4816.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3637.57
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tapentadol & Metabolite So",
      "code_information": [
        {
          "code": "PX-30101098",
          "type": "CDM"
        },
        {
          "code": "80372",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 208,
          "discounted_cash": 135.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 130
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 151.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 130
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.56
            },
            {
              "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": 130
            },
            {
              "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": 130
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 115.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.56
            },
            {
              "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": 52
            },
            {
              "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": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 208,
              "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": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 130
            },
            {
              "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": 104
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 208
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 115.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 115.44
            },
            {
              "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": 130
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.4
            },
            {
              "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": 135.2
            },
            {
              "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": 114.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.4
            },
            {
              "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": 115.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 176.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 93.6
            },
            {
              "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": 208,
              "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": 183.04
            },
            {
              "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": 176.8
            },
            {
              "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": 93.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 130
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 151.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "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": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 208,
              "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": 45,
              "estimated_amount": 93.6
            },
            {
              "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": 170.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 62.5,
              "estimated_amount": 130
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 208,
              "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": 208,
              "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": 176.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 130
            },
            {
              "payer_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": 130
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 151.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 151.84
            },
            {
              "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": 208,
              "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": 176.8
            },
            {
              "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": 170.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 151.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 208,
              "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": 45,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 130
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 50,
              "estimated_amount": 104
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.4
            },
            {
              "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": 151.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 176.8
            },
            {
              "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": 208,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 93.6
            },
            {
              "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": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 208,
              "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": 62.5,
              "estimated_amount": 130
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.56
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "Mrph Alys Ish Quant Semiq Man Addl Sendout",
      "code_information": [
        {
          "code": "PX-31000136",
          "type": "CDM"
        },
        {
          "code": "88369",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1100,
          "discounted_cash": 715,
          "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": 706.2
            },
            {
              "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": 706.2
            },
            {
              "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": 716.1
            },
            {
              "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": 1100,
              "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": 964.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39,
              "estimated_amount": 39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39,
              "estimated_amount": 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": 902
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "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": 911.9
            },
            {
              "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": 300.3
            },
            {
              "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": 715
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "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": 935
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1100,
              "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": 706.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 889.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1100,
              "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": 1100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "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": 1100,
              "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": 706.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "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": 716.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 968
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "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": 1100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 825
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "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": 610.5
            },
            {
              "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": 803
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1100,
              "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": 889.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "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": 695.2
            },
            {
              "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": 964.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1100,
              "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": 1100,
              "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": 610.5
            },
            {
              "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": 610.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 825
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "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": 1100,
              "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": 911.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 716.1
            },
            {
              "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": 902
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 610.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "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": 1100,
              "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": 935
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "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": 706.2
            },
            {
              "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": 695.2
            },
            {
              "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": 1100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 716.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1100,
              "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": 240.9
            },
            {
              "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": 706.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 716.1
            },
            {
              "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": 1100,
              "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": 1100
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 911.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "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": 1100,
              "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": 695.2
            },
            {
              "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": 1100,
              "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": 706.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1100,
              "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": 695.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 825
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 340.58,
              "estimated_amount": 340.58
            }
          ],
          "minimum": 39,
          "maximum": 340.58
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Highbanks",
      "code_information": [
        {
          "code": "PX-65900123",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 241.64,
          "discounted_cash": 157.07,
          "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": 155.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 241.64,
              "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": 241.64,
              "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": 241.64,
              "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": 241.64,
              "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": 132.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.13
            },
            {
              "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": 195.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 181.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.4
            },
            {
              "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": 155.13
            },
            {
              "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": 155.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 205.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 241.64,
              "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": 157.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 132.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.4
            },
            {
              "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": 198.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 132.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "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": 211.92
            },
            {
              "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": 134.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 132.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 198.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 132.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 200.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 241.64,
              "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": 241.64,
              "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": 200.32
            },
            {
              "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": 65.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.14
            },
            {
              "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": 212.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.4
            },
            {
              "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": 176.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 241.64,
              "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": 181.23
            },
            {
              "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": 152.72
            },
            {
              "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": 157.31
            },
            {
              "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": 132.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.13
            },
            {
              "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": 198.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 241.64
            },
            {
              "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": 205.39
            },
            {
              "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": 152.72
            },
            {
              "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": 152.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 241.64,
              "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": 134.11
            },
            {
              "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": 134.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 134.11
            },
            {
              "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": 211.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 157.31
            },
            {
              "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": 157.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 157.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.14
            },
            {
              "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": 241.64,
              "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": 200.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 195.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 132.9
            },
            {
              "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": 155.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.72
            },
            {
              "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": 205.39
            },
            {
              "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": 155.13
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Laurels Athens",
      "code_information": [
        {
          "code": "PX-65900126",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 218.44,
          "discounted_cash": 141.99,
          "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": 140.24
            },
            {
              "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": 140.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 218.44,
              "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": 120.14
            },
            {
              "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": 179.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 163.83
            },
            {
              "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": 121.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 181.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.05
            },
            {
              "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": 138.05
            },
            {
              "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": 192.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 176.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.05
            },
            {
              "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": 218.44,
              "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": 185.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 218.44,
              "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": 185.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 142.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.12
            },
            {
              "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": 59.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 163.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.24
            },
            {
              "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": 121.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 218.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 120.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 140.24
            },
            {
              "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": 176.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.05
            },
            {
              "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": 181.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 121.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 142.2
            },
            {
              "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": 179.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 218.44,
              "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": 140.24
            },
            {
              "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": 140.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 121.23
            },
            {
              "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": 142.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.05
            },
            {
              "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": 191.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 140.24
            },
            {
              "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": 140.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 181.09
            },
            {
              "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": 159.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.24
            },
            {
              "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": 140.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 138.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 142.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 163.83
            },
            {
              "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": 191.57
            },
            {
              "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": 138.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.67
            },
            {
              "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": 120.14
            },
            {
              "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": 185.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 218.44,
              "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": 185.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 179.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 218.44,
              "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": 218.44,
              "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": 142.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.14
            },
            {
              "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": 140.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.46
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Mayfair Village",
      "code_information": [
        {
          "code": "PX-65900133",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 216.09,
          "discounted_cash": 140.46,
          "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": 138.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 162.07
            },
            {
              "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": 138.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 174.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.75
            },
            {
              "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": 140.67
            },
            {
              "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": 140.67
            },
            {
              "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": 177.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 216.09,
              "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": 216.09,
              "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": 138.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.75
            },
            {
              "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": 119.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 183.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 179.14
            },
            {
              "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": 177.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 177.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 216.09,
              "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": 177.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 177.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "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": 136.57
            },
            {
              "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": 136.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.85
            },
            {
              "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": 138.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 119.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 179.14
            },
            {
              "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": 119.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 138.73
            },
            {
              "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": 216.09,
              "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": 216.09,
              "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": 118.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.73
            },
            {
              "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": 138.73
            },
            {
              "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": 183.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 138.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "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": 190.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 216.09,
              "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": 138.73
            },
            {
              "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": 119.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 174.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 177.19
            },
            {
              "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": 183.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.85
            },
            {
              "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": 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": 179.14
            },
            {
              "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": 138.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 216.09,
              "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": 177.19
            },
            {
              "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": 157.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 136.57
            },
            {
              "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": 189.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 216.09
            },
            {
              "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": 118.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 157.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.57
            },
            {
              "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": 189.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 136.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.68
            },
            {
              "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": 177.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 216.09,
              "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": 183.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 162.07
            }
          ]
        }
      ]
    },
    {
      "description": "Gloves Nitrile Powder-Free Esteem Xp Med Extended Cuff",
      "code_information": [
        {
          "code": "PX-CHA1N8852XPB",
          "type": "CDM"
        },
        {
          "code": "A927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.14,
          "discounted_cash": 0.09,
          "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": 0.09
            },
            {
              "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": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "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 OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "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": "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": "AETNA [310]",
              "plan_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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.11
            },
            {
              "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": 0.14,
              "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": 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": 0.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "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": 0.08
            },
            {
              "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": "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 CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.11
            },
            {
              "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": 0.08
            },
            {
              "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
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "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": "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": "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": "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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.14,
              "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": 0.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "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": 0.09
            },
            {
              "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": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "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": 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": 0.12
            },
            {
              "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": "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": "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": "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/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "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": "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 OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "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": "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": "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": "AVALON HEALTHREACH OH [540410]",
              "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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.09
            },
            {
              "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": "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": "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": "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 OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.09
            },
            {
              "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": 0.14,
              "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": 0.1
            },
            {
              "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": "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": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "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": 0.09
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "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": 0.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "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": "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": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "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": 0.12
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.09
            },
            {
              "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": 0.09
            },
            {
              "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": 0.12
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.09
            },
            {
              "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": 0.09
            },
            {
              "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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.14,
              "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": 0.12
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Pre Cut Std Wear 1 1-4 in Active Life",
      "code_information": [
        {
          "code": "PX-CHCV022759",
          "type": "CDM"
        },
        {
          "code": "A5061",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.1,
          "discounted_cash": 3.96,
          "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": 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
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 3.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "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": "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": "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 UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 3.36
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "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": "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "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": 6.1,
              "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": 6.1,
              "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": 6.1,
              "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": 3.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "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": 5.19
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.97
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 6.1,
              "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": 5.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.1,
              "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": 3.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.39
            },
            {
              "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": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 6.1,
              "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": 1.67
            },
            {
              "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": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 6.1,
              "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": 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": 3.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.58
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 6.1,
              "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": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 3.36
            },
            {
              "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": 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": 3.92
            },
            {
              "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": 3.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 6.1,
              "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": 4.93
            },
            {
              "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": 3.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "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": 4.45
            },
            {
              "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": "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": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "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": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 3.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 5.35
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 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": 3.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "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": 6.1,
              "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": 3.92
            },
            {
              "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": "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 HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "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": 6.1
            },
            {
              "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": 5.19
            },
            {
              "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": 3.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "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": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Ctf Std Wear Up to 2 3-8 in Esteem",
      "code_information": [
        {
          "code": "PX-CHCV405458",
          "type": "CDM"
        },
        {
          "code": "A4414",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.97,
          "discounted_cash": 5.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.12
            },
            {
              "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": 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": 5.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.97,
              "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": 5.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.12
            },
            {
              "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": 5.19
            },
            {
              "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": 6.54
            },
            {
              "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": 5.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.77
            },
            {
              "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": 7.97,
              "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": 5.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.38
            },
            {
              "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": 7.97,
              "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": 4.42
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.97,
              "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": 6.77
            },
            {
              "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": 7.01
            },
            {
              "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": 7.97,
              "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": 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": 6.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 7.97,
              "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": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 6.61
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.38
            },
            {
              "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": 5.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.82
            },
            {
              "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": 5.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 7.97,
              "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": 2.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.54
            },
            {
              "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": 6.99
            },
            {
              "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": 5.12
            },
            {
              "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": 7.97,
              "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": 4.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.77
            },
            {
              "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": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 6.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.12
            },
            {
              "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": 7.97,
              "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": 6.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.38
            },
            {
              "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": 7.97,
              "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": 7.97,
              "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": 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": 5.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 7.97,
              "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": 6.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 5.04
            },
            {
              "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": 7.97,
              "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": 5.98
            },
            {
              "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": 7.97,
              "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": 7.97,
              "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": 5.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.04
            },
            {
              "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": 7.97,
              "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": 7.97,
              "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": 7.97
            },
            {
              "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": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 7.97,
              "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": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 7.97,
              "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": 7.97,
              "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": 5.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.12
            },
            {
              "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": 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": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.97,
              "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": 7.97,
              "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": 7.97,
              "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": 6.45
            },
            {
              "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": 6.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.77
            },
            {
              "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": 5.04
            },
            {
              "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": 7.97,
              "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": 4.38
            },
            {
              "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": 5.04
            },
            {
              "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": 6.99
            },
            {
              "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": 7.97,
              "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": 4.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.97,
              "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": 7.97,
              "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": 7.97,
              "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": 7.97,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrofiber Foam Adhesive Aquacel 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CHCV420680",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.33,
          "discounted_cash": 4.11,
          "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": 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": 4.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 6.33,
              "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": 3.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.33
            },
            {
              "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": 5.25
            },
            {
              "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": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 4.06
            },
            {
              "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": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 4.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 4.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 5.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.38
            },
            {
              "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": 6.33,
              "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": 3.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.62
            },
            {
              "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": 6.33,
              "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": 6.33,
              "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": 6.33,
              "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": 6.33,
              "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
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.38
            },
            {
              "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": 6.33,
              "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": 5.19
            },
            {
              "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": 6.33,
              "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": 3.51
            },
            {
              "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": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 6.33,
              "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": 6.33,
              "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": 4.62
            },
            {
              "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": 6.33,
              "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": 4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.48
            },
            {
              "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": 6.33,
              "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": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 5.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 5.19
            },
            {
              "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": 4.06
            },
            {
              "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": 6.33,
              "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": 6.33,
              "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": 4.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.12
            },
            {
              "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
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.48
            },
            {
              "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": 6.33,
              "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": 5.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.12
            },
            {
              "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": 6.33,
              "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": 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": 5.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 4.62
            },
            {
              "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": 6.33,
              "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": 5.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.06
            },
            {
              "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": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 6.33,
              "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": 6.33,
              "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": 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": 4.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.19
            },
            {
              "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": 5.19
            },
            {
              "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": 6.33,
              "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": 6.33,
              "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": 4.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.62
            },
            {
              "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": 6.33,
              "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
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 3.48
            },
            {
              "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": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 5.38
            },
            {
              "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": 5.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.38
            },
            {
              "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": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.33,
              "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": 6.33,
              "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": 6.33,
              "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": 6.33,
              "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": 6.33,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "\"2 Pc Ctf Std Wear Sensura Flex Up to 3 1-2\"\" Stoma 3 1-2\"\" Flg\"",
      "code_information": [
        {
          "code": "PX-CHCO10108",
          "type": "CDM"
        },
        {
          "code": "A4415",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.04,
          "discounted_cash": 5.23,
          "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": 5.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.59
            },
            {
              "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": 8.04,
              "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": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 8.04,
              "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": 6.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 6.5
            },
            {
              "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": 7.05
            },
            {
              "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": 5.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 6.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 5.16
            },
            {
              "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": 5.23
            },
            {
              "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": 7.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 7.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.16
            },
            {
              "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": 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": 5.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.83
            },
            {
              "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": 8.04,
              "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": 6.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 8.04,
              "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": 8.04,
              "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": 8.04,
              "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": 5.08
            },
            {
              "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": 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": 8.04,
              "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": 6.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.87
            },
            {
              "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": 5.08
            },
            {
              "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": 8.04,
              "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": 6.83
            },
            {
              "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": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 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": 5.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.08
            },
            {
              "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": 6.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.83
            },
            {
              "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": 6.67
            },
            {
              "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": 2.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 8.04,
              "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": 8.04,
              "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": 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": 5.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 6.83
            },
            {
              "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": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 8.04,
              "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": 5.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.03
            },
            {
              "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": 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": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 6.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.87
            },
            {
              "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": 5.87
            },
            {
              "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": 4.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.87
            },
            {
              "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": 6.83
            },
            {
              "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": 5.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.04,
              "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": 5.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 6.83
            },
            {
              "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": 5.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.16
            },
            {
              "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": 4.46
            },
            {
              "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": 8.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 8.04
            }
          ]
        }
      ]
    },
    {
      "description": "Mask Earloop Yellow Cardinal Prffered",
      "code_information": [
        {
          "code": "PX-CH55AT7004",
          "type": "CDM"
        },
        {
          "code": "A4928",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.13,
          "discounted_cash": 0.08,
          "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": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.1
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.08
            },
            {
              "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": 0.13,
              "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": 0.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "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": 0.13,
              "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": 0.08
            },
            {
              "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": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.11
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "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": 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": 0.08
            },
            {
              "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": 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": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.09
            },
            {
              "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": 0.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.07
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.13,
              "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": 0.13,
              "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": 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": 0.13,
              "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": 0.13,
              "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": 0.08
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.13,
              "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": 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": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.07
            },
            {
              "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": 0.08
            },
            {
              "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": 0.13,
              "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": 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": 0.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.13,
              "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": 0.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.08
            },
            {
              "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": 0.11
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.08
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.11
            },
            {
              "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": 0.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.13,
              "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": 0.13,
              "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": 0.11
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.13
            }
          ]
        }
      ]
    },
    {
      "description": "Elbow Protector Safegaurd Med Blue Ea = 1 (Pair)",
      "code_information": [
        {
          "code": "PX-CHMTICMED60",
          "type": "CDM"
        },
        {
          "code": "E0191",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.91,
          "discounted_cash": 6.44,
          "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": 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": 8.13
            },
            {
              "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": 8.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 8.02
            },
            {
              "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": 7.23
            },
            {
              "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": 6.36
            },
            {
              "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": 9.91,
              "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": 9.91,
              "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": 9.91,
              "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": 8.22
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.23
            },
            {
              "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": 8.69
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 6.36
            },
            {
              "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": 8.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 6.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.36
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 8.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.36
            },
            {
              "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": 6.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 9.91,
              "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": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.23
            },
            {
              "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": 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": 8.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 9.91,
              "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": 6.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.91,
              "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": 7.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 6.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 8.72
            },
            {
              "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": 9.91,
              "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": 9.91,
              "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": 6.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 6.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 8.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 5.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 9.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 6.26
            },
            {
              "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": 5.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.43
            },
            {
              "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": 8.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.23
            },
            {
              "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": 5.5
            },
            {
              "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": 6.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.02
            },
            {
              "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": 8.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.91,
              "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": 6.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.42
            },
            {
              "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": 8.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.22
            }
          ]
        }
      ]
    },
    {
      "description": "Genetic Testing for Severe Inherited Conditions Sendout",
      "code_information": [
        {
          "code": "PX-30101443",
          "type": "CDM"
        },
        {
          "code": "81443",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6075,
          "discounted_cash": 3948.75,
          "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": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4434.75
            },
            {
              "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": 5346
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2473.05,
              "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_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2570.99,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6075,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "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": 1330.43
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2570.99,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4556.25
            },
            {
              "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": 3341.25
            },
            {
              "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": 4434.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4981.5
            },
            {
              "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": 6075,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2473.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2473.05,
              "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": 4981.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6075,
              "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": 6075,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "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": 4981.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3341.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6075,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "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": 3796.88
            },
            {
              "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": 3037.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "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": 4981.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1701.25,
              "estimated_amount": 1701.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3341.25
            },
            {
              "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": 3796.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4981.5
            },
            {
              "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": 1518.75
            },
            {
              "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": 3948.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2473.05,
              "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": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "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": 6075,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2502.65,
              "estimated_amount": 2502.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4981.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3341.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3341.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1701.25,
              "estimated_amount": 1701.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1701.25,
              "estimated_amount": 1701.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4434.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4434.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2502.65,
              "estimated_amount": 2502.65
            },
            {
              "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": 3796.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "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": 3796.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "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": 5163.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2448.56,
              "estimated_amount": 2448.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4556.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "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": 3037.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4556.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4434.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6075,
              "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": 3341.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9182.1,
              "estimated_amount": 9182.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3037.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3341.25
            },
            {
              "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": 5163.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1701.25,
              "estimated_amount": 1701.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5163.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4434.75
            },
            {
              "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": 4981.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6075,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 3796.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4981.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2570.99,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 2448.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2473.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 1701.25,
          "maximum": 9182.1
        }
      ]
    },
    {
      "description": "Unpinning Ice Catheter",
      "code_information": [
        {
          "code": "PX-62400212",
          "type": "CDM"
        },
        {
          "code": "C1759",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1,
          "discounted_cash": 0.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.56
            },
            {
              "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": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 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": 0.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.82
            },
            {
              "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": 0.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 1,
              "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": 0.82
            },
            {
              "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": 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": 1,
              "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": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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": 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": 0.27
            },
            {
              "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": 0.85
            },
            {
              "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": 1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 1,
              "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": 0.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 0.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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,
              "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": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 1,
              "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": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.55
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 1,
              "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": 0.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.64
            },
            {
              "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": 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": 0.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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": 1,
              "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": 0.85
            },
            {
              "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": 0.64
            },
            {
              "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": 0.81
            },
            {
              "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": 0.56
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 1,
              "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": 1,
              "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": 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": 0.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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 percent of billed.",
              "estimated_amount": 1,
              "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": 0.64
            },
            {
              "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": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 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": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "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": 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": 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": 0.64
            },
            {
              "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": 1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 1,
              "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": 0.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "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": 0.88
            },
            {
              "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": 1,
              "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": 0.85
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.63
            },
            {
              "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": 1,
              "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": 1,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 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": 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": 1,
              "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": 1,
              "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": 0.85
            },
            {
              "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": 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": 0.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.75
            },
            {
              "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": 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": 0.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "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": 1,
              "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": 0.63
            },
            {
              "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": 0.73
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 1,
              "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": 1,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Pre Cut Ext Wear 1 1-4 in Premier",
      "code_information": [
        {
          "code": "PX-CHHO8538",
          "type": "CDM"
        },
        {
          "code": "A4388",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.01,
          "discounted_cash": 4.56,
          "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": 4.5
            },
            {
              "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": 4.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 7.01,
              "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": 5.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.75
            },
            {
              "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": 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": 5.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 4.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "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": 5.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 7.01,
              "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": 5.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.43
            },
            {
              "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": 5.96
            },
            {
              "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": 5.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 7.01,
              "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": 7.01,
              "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": 7.01,
              "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": 5.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 5.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.86
            },
            {
              "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": 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": 4.5
            },
            {
              "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": 4.5
            },
            {
              "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": 6.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 4.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.56
            },
            {
              "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": 7.01,
              "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": 7.01,
              "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": 7.01,
              "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": 7.01
            },
            {
              "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": 3.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.56
            },
            {
              "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": 3.86
            },
            {
              "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": 4.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.75
            },
            {
              "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": 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": 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": 4.43
            },
            {
              "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": 7.01,
              "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": 3.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 5.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.5
            },
            {
              "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": 4.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.86
            },
            {
              "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": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 4.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 5.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 5.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 7.01,
              "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": 5.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.26
            },
            {
              "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": 1.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 4.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.01,
              "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": 5.96
            },
            {
              "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": 6.17
            },
            {
              "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": 4.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.26
            },
            {
              "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": 4.5
            },
            {
              "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": 7.01,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Cvx Uro Up to 1 in Premier",
      "code_information": [
        {
          "code": "PX-CHHO8474",
          "type": "CDM"
        },
        {
          "code": "A4430",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.34,
          "discounted_cash": 8.67,
          "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": 8.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 11.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.94
            },
            {
              "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": 8.56
            },
            {
              "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": 10.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 13.34,
              "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": 7.34
            },
            {
              "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": 8.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 8.43
            },
            {
              "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": 9.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 8.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.34,
              "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": 10.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.01
            },
            {
              "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": 11.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 7.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 13.34,
              "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": 13.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.94
            },
            {
              "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": 3.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 11.34
            },
            {
              "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": 8.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 8.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.34
            },
            {
              "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": 8.68
            },
            {
              "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": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 7.4
            },
            {
              "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": 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": 13.34,
              "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": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 8.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.68
            },
            {
              "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": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 11.34
            },
            {
              "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": 11.7
            },
            {
              "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": 8.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.56
            },
            {
              "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": 10.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 11.06
            },
            {
              "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": 8.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.34,
              "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": 9.74
            },
            {
              "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": 13.34,
              "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": 11.34
            },
            {
              "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": 10.79
            },
            {
              "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": 8.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.34,
              "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": 11.74
            },
            {
              "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": 13.34,
              "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": 8.43
            },
            {
              "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": 13.34,
              "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": 13.34,
              "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": 10.94
            },
            {
              "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": 8.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.56
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch Closed End W Filter Sensura Mio Click 70mm Yellow",
      "code_information": [
        {
          "code": "PX-CHCO11426",
          "type": "CDM"
        },
        {
          "code": "A4423",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.57,
          "discounted_cash": 1.67,
          "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": 1.65
            },
            {
              "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": 1.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 1.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.11
            },
            {
              "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": 2.25
            },
            {
              "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": 2.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.65
            },
            {
              "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": 1.62
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.57,
              "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": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 1.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.57,
              "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": 1.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 1.88
            },
            {
              "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": 1.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 2.57,
              "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": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 1.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 2.08
            },
            {
              "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": 2.08
            },
            {
              "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": 2.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 2.26
            },
            {
              "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": 2.57,
              "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": 2.57,
              "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": 1.65
            },
            {
              "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": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 2.57,
              "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": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 1.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.65
            },
            {
              "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": 2.57,
              "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": 1.62
            },
            {
              "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": 1.65
            },
            {
              "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": 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": 1.43
            },
            {
              "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": 1.67
            },
            {
              "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": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 1.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 1.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 2.57,
              "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": 2.57,
              "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": 2.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.11
            },
            {
              "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": 2.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.67
            },
            {
              "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": 2.13
            },
            {
              "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": 2.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.65
            },
            {
              "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": 1.41
            },
            {
              "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": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.57,
              "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": 2.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 1.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.62
            },
            {
              "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": 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": 1.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.88
            }
          ]
        }
      ]
    },
    {
      "description": "Full Suction Kit",
      "code_information": [
        {
          "code": "PX-CHFHAG5603",
          "type": "CDM"
        },
        {
          "code": "E1399",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 33.94,
          "discounted_cash": 22.06,
          "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": 21.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 18.84
            },
            {
              "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": 21.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 33.94,
              "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": 21.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 29.77
            },
            {
              "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": 27.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "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": 28.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.94,
              "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": 21.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.79
            },
            {
              "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": 21.79
            },
            {
              "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": 29.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 33.94,
              "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": 28.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.78
            },
            {
              "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": 21.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 33.94,
              "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": 21.45
            },
            {
              "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": 21.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "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": 21.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.79
            },
            {
              "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": 22.09
            },
            {
              "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": 27.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "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": 18.84
            },
            {
              "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": 29.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 22.09
            },
            {
              "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": 27.83
            },
            {
              "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": 33.94,
              "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": 27.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 33.94,
              "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": 18.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 28.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.46
            },
            {
              "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": 18.67
            },
            {
              "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": 22.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 21.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 33.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.14
            },
            {
              "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": 28.85
            },
            {
              "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": 33.94,
              "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": 9.27
            },
            {
              "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": 33.94,
              "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": 27.83
            },
            {
              "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": 18.84
            },
            {
              "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": 33.94,
              "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": 21.79
            },
            {
              "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": 21.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.45
            },
            {
              "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": 22.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.46
            },
            {
              "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": 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": 24.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 18.67
            },
            {
              "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": 21.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 18.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "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": 18.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "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": 24.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 33.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Exam of Cervix Including Upper/Adjacent Vagina",
      "code_information": [
        {
          "code": "PX-36100970",
          "type": "CDM"
        },
        {
          "code": "57452",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 502,
          "discounted_cash": 326.3,
          "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": 322.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 502,
              "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": 502,
              "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": 426.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "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": 322.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "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": 440.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 440.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "additional_payer_notes": "OP SURG "
            },
            {
              "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": 502,
              "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": 426.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "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": 326.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 416.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "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": 426.7
            },
            {
              "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": 326.3
            },
            {
              "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": 326.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "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": 411.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 376.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 502,
              "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": 376.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 376.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 276.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "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": 411.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 411.64
            },
            {
              "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": 317.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 502,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 137.05
            },
            {
              "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": 322.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "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": 502,
              "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": 326.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 416.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "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": 502,
              "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": 502,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 502,
              "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": 426.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 502,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 502,
              "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": 317.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 276.1
            },
            {
              "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": 276.1
            },
            {
              "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": 441.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 406.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 406.12
            },
            {
              "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": 366.46
            },
            {
              "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": 322.28
            },
            {
              "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": 322.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "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": 317.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "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": 502,
              "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": 416.16
            }
          ]
        }
      ]
    },
    {
      "description": "HC Albumin Specials",
      "code_information": [
        {
          "code": "PX-30101474",
          "type": "CDM"
        },
        {
          "code": "82040",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10,
          "discounted_cash": 6.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5,
              "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": 6.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 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": 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": 8.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.95,
              "estimated_amount": 4.95
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.95,
              "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": 7.3
            },
            {
              "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/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": 2.73
            },
            {
              "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": 10,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": 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": 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": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": 8.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.95,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": 6.42
            },
            {
              "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": 8.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5,
              "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": 6.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.24,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.95,
              "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": 6.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.24,
              "estimated_amount": 7.24
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.2,
              "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": 6.51
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 6.42
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": "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/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.95,
              "estimated_amount": 4.95
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.24,
              "estimated_amount": 7.24
            },
            {
              "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.2,
              "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": 8.5
            },
            {
              "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": "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 6.32
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.95,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "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": 10,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": 8.5
            },
            {
              "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": 6.32
            },
            {
              "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": "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": "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "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": 6.32
            },
            {
              "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": 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 BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5,
              "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": 6.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.95,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.56,
              "estimated_amount": 18.56
            }
          ],
          "minimum": 4.95,
          "maximum": 18.56
        }
      ]
    },
    {
      "description": "Foldax Polymer Aortic Valve",
      "code_information": [
        {
          "code": "PX-62400215",
          "type": "CDM"
        },
        {
          "code": "L8699",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1,
          "discounted_cash": 0.65,
          "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": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.64
            },
            {
              "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": 0.65
            },
            {
              "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": 1,
              "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": 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,
              "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,
              "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": 0.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "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": 1,
              "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": 1,
              "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,
              "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,
              "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": 1,
              "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": 0.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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,
              "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": 0.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.55
            },
            {
              "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": 1,
              "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": 1,
              "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": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.65
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1,
              "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": 0.63
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "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": 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": 0.73
            },
            {
              "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": 0.56
            },
            {
              "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": 1,
              "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,
              "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": 0.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1,
              "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": 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": 1,
              "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": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "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": 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,
              "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": 0.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 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": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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": 0.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 1,
              "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": 0.82
            },
            {
              "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": 1,
              "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": 1,
              "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": 1,
              "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": 0.64
            },
            {
              "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": 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": 0.27
            },
            {
              "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": 0.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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,
              "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": 0.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 0.64
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "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": 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": 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": 1,
              "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": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "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": 1,
              "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": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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": 0.83
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.63
            },
            {
              "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": 1,
              "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": 0.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "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": 1,
              "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": 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": 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": 0.75
            },
            {
              "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": 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": 0.64
            },
            {
              "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": 0.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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,
              "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,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter 100% Silicone 2-Way 22 Fr 30 Cc",
      "code_information": [
        {
          "code": "PX-CHKN7630229",
          "type": "CDM"
        },
        {
          "code": "A4344",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.17,
          "discounted_cash": 8.56,
          "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": 8.46
            },
            {
              "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": 13.17,
              "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": 11.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 9.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.61
            },
            {
              "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": 8.46
            },
            {
              "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": 8.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.8
            },
            {
              "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": 13.17,
              "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": 8.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 8.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.24
            },
            {
              "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": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 7.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.61
            },
            {
              "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": 13.17,
              "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": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 13.17,
              "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": 11.19
            },
            {
              "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": 11.55
            },
            {
              "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": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 13.17,
              "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": 8.46
            },
            {
              "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": 10.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 13.17,
              "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": 9.61
            },
            {
              "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": 13.17,
              "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": 10.8
            },
            {
              "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": 8.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 8.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 9.61
            },
            {
              "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": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 10.8
            },
            {
              "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": 10.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 13.17,
              "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": 11.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.57
            },
            {
              "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": 10.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.17,
              "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": 8.32
            },
            {
              "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": 13.17,
              "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": 13.17,
              "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": 13.17,
              "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": 13.17,
              "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": 11.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.92
            },
            {
              "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": 7.24
            },
            {
              "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": 13.17,
              "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": 8.46
            },
            {
              "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": 13.17,
              "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": 13.17,
              "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": 8.32
            },
            {
              "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": 8.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.46
            },
            {
              "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": 8.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 13.17,
              "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": 9.61
            },
            {
              "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": 13.17,
              "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": 13.17,
              "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": 8.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.32
            },
            {
              "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": 11.55
            },
            {
              "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": 7.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.88
            },
            {
              "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": 11.19
            },
            {
              "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": 13.17,
              "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": 7.24
            },
            {
              "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": 9.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.46
            },
            {
              "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": 13.17,
              "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": 10.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.57
            },
            {
              "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": 10.8
            },
            {
              "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": 13.17,
              "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": 13.17,
              "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": 13.17,
              "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": 13.17,
              "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": 13.17,
              "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": 13.17,
              "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": 8.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.19
            },
            {
              "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": 13.17,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Shampoo-Body Wash-Peri-Foam 7-3/4 Oz Aloe Vera 3 in 1",
      "code_information": [
        {
          "code": "PX-CHDERMA190",
          "type": "CDM"
        },
        {
          "code": "A4335",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.6,
          "discounted_cash": 4.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 4.24
            },
            {
              "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": 6.6,
              "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": 6.6,
              "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": 3.63
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.6,
              "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": 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": "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.6,
              "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": 4.24
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 4.24
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 6.6,
              "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": 6.6,
              "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": 5.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "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": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.3
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 5.61
            },
            {
              "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": 6.6,
              "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": 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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.6,
              "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": 3.63
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "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": 4.82
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.34
            },
            {
              "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": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 5.47
            },
            {
              "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": 4.17
            },
            {
              "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": 6.6,
              "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": 6.6,
              "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": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 4.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "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": 6.6,
              "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": 3.63
            },
            {
              "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": 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": 4.24
            },
            {
              "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": 6.6,
              "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": 6.6,
              "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": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 1.8
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "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": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 4.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.6,
              "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": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 5.61
            },
            {
              "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": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 4.17
            },
            {
              "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": 5.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "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": 6.6,
              "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": 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": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 5.47
            },
            {
              "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": 6.6,
              "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": 5.61
            },
            {
              "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": 5.61
            },
            {
              "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.6,
              "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": 6.6,
              "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": 4.24
            },
            {
              "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": 4.3
            },
            {
              "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": 6.6,
              "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": 5.81
            }
          ]
        }
      ]
    },
    {
      "description": "HC Renal Function Panel",
      "code_information": [
        {
          "code": "PX-30100008",
          "type": "CDM"
        },
        {
          "code": "80069",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 66,
          "discounted_cash": 42.9,
          "minimum": 7.14,
          "maximum": 32.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.68,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.69,
              "estimated_amount": 12.69
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "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 CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.69,
              "estimated_amount": 12.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.77,
              "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": 48.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.14,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.69,
              "estimated_amount": 12.69
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "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": 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": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "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": 16.5
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "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": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.68,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.68,
              "estimated_amount": 8.68
            },
            {
              "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": 56.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.14,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "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": 54.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 29.7
            },
            {
              "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": 66,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.68,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.77,
              "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": 56.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.68,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.68,
              "estimated_amount": 8.68
            },
            {
              "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": 36.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.11,
              "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": 45,
              "estimated_amount": 29.7
            },
            {
              "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": 29.7
            },
            {
              "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": 58.08
            },
            {
              "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": 33
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "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": 54.12
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.14,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.14,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "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": 54.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.68,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "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": "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 OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "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": 42.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "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": 54.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 8.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.77,
              "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": 66,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "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": 29.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.08,
              "estimated_amount": 18.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.55,
              "estimated_amount": 32.55
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 66,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Gentamicin",
      "code_information": [
        {
          "code": "PX-30100025",
          "type": "CDM"
        },
        {
          "code": "80170",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 59,
          "discounted_cash": 38.35,
          "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": 37.88
            },
            {
              "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": 37.88
            },
            {
              "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": 47.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "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": 51.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "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": 16.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.54,
              "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": 37.29
            },
            {
              "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": 32.75
            },
            {
              "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": 37.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "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": 51.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 32.45
            },
            {
              "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": 43.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 44.25
            },
            {
              "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": 32.45
            },
            {
              "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": 38.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 43.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 38.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 48.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 32.45
            },
            {
              "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": 50.15
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 48.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 48.91
            },
            {
              "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": 48.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.2,
              "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": 32.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "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": 38.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.54,
              "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": 59,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.54,
              "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": 51.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 38.41
            },
            {
              "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": 37.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 37.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 43.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 43.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 48.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 48.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 32.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.88
            },
            {
              "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": 37.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 48.38
            },
            {
              "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": 48.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.54,
              "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": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "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": 50.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 37.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 32.45
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.2,
              "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": 32.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.54,
              "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": 47.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 48.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 43.07
            },
            {
              "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": 37.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "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": 59,
              "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": 50.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 37.29
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "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": 32.75
            },
            {
              "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": 37.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "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": 48.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 38.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 43.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 37.29
            },
            {
              "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": 32.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.88
            },
            {
              "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": 38.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.43,
              "estimated_amount": 61.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 50.15
            },
            {
              "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": 37.29
            },
            {
              "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": 59,
              "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": 32.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            }
          ],
          "minimum": 16.38,
          "maximum": 61.43
        }
      ]
    },
    {
      "description": "HC Infusion Therapy Sequential Drug Up to 1 Hr",
      "code_information": [
        {
          "code": "PX-26000005",
          "type": "CDM"
        },
        {
          "code": "96367",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 324,
          "discounted_cash": 210.6,
          "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": 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": 64.56,
              "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": 61.48,
              "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": 62.74,
              "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": 179.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 268.6
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 179.82
            },
            {
              "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": 265.68
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.1,
              "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": 62.1,
              "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": 324,
              "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": 204.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 275.4
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 262.12
            },
            {
              "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": "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": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 275.4
            },
            {
              "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": 61.48,
              "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": 324,
              "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": 324,
              "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": 62.1,
              "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": 208.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 324,
              "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": 210.6
            },
            {
              "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": 62.1,
              "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": 324,
              "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": 62.74,
              "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": 64.56,
              "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": 243
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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": "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 275.4
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 178.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 236.52
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 61.48,
              "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": 204.77
            },
            {
              "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": 204.77
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 324,
              "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": 265.68
            },
            {
              "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": 268.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 208.01
            },
            {
              "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": 262.12
            },
            {
              "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": "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": "MOLINA 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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "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": 208.01
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "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": "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": "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.1,
              "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": 178.2
            },
            {
              "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": 275.4
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 179.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "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": 88.45
            },
            {
              "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": 61.48,
              "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": 178.2
            },
            {
              "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": "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": "UHC 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": "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": "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": "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": "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 243
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 62.74,
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 324,
              "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": 178.2
            },
            {
              "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": 265.68
            },
            {
              "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.56,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Absorption Dressing Drawtex 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-ELTA-00302",
          "type": "CDM"
        },
        {
          "code": "A6197",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.86,
          "discounted_cash": 7.71,
          "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": 7.61
            },
            {
              "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": 6.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.72
            },
            {
              "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": 11.86,
              "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": 9.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 7.72
            },
            {
              "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": 11.86,
              "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": 8.66
            },
            {
              "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": 11.86,
              "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": 7.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.9
            },
            {
              "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": 11.86,
              "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": 11.86,
              "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": 9.59
            },
            {
              "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": 6.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.86,
              "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": 7.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.08
            },
            {
              "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": 11.86,
              "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": 10.08
            },
            {
              "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": 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": 10.4
            },
            {
              "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": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 11.86,
              "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": 7.72
            },
            {
              "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": 11.86,
              "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": 7.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.52
            },
            {
              "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": 8.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.61
            },
            {
              "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": 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": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 11.86,
              "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": 6.58
            },
            {
              "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": 11.86,
              "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": 11.86,
              "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": 11.86,
              "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": 11.86,
              "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": 11.86,
              "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": 11.86,
              "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": 9.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 11.86,
              "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": 6.52
            },
            {
              "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": 7.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 11.86,
              "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": 10.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 8.66
            },
            {
              "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": 9.73
            },
            {
              "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": 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": 9.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 11.86,
              "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": 8.66
            },
            {
              "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": 11.86,
              "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": 11.86,
              "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": 11.86,
              "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": 11.86,
              "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": 10.08
            },
            {
              "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": 10.08
            },
            {
              "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": 11.86,
              "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": 7.72
            },
            {
              "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": 7.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.73
            },
            {
              "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": 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": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.86,
              "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": 11.86,
              "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": 10.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 10.4
            },
            {
              "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": 11.86,
              "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": 10.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.61
            },
            {
              "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": 11.86,
              "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": 7.61
            },
            {
              "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": 11.86,
              "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": 6.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.83
            },
            {
              "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": 7.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.73
            },
            {
              "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": 10.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.08
            },
            {
              "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": 10.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.61
            }
          ]
        }
      ]
    },
    {
      "description": "HC Phototherapy per Day",
      "code_information": [
        {
          "code": "PX-27100019",
          "type": "CDM"
        },
        {
          "code": "27100019",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 339,
          "discounted_cash": 220.35,
          "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": 217.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 274.25
            },
            {
              "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": 186.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 214.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 281.03
            },
            {
              "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": 281.03
            },
            {
              "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": 214.25
            },
            {
              "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": 297.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217.64
            },
            {
              "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": 92.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 188.15
            },
            {
              "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": 339,
              "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": 220.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "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": 298.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 186.45
            },
            {
              "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": 277.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 254.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 220.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 186.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 247.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217.64
            },
            {
              "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": 220.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 247.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 247.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 186.45
            },
            {
              "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": 188.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "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": 212.89
            },
            {
              "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": 220.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 220.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 339
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 247.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "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": 277.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.98
            },
            {
              "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": 339,
              "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": 254.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 339,
              "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": 217.64
            },
            {
              "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": 274.25
            },
            {
              "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": 214.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 214.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "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": 297.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "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": 217.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 214.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 220.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 254.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 186.45
            },
            {
              "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": 288.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 281.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 186.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 220.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217.64
            },
            {
              "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": 220.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 214.25
            },
            {
              "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": 339,
              "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": 288.15
            },
            {
              "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": 188.15
            },
            {
              "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": 217.64
            },
            {
              "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": 288.15
            },
            {
              "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": 214.25
            },
            {
              "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": 212.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 288.15
            },
            {
              "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": 277.98
            },
            {
              "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": 188.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 214.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 220.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 186.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 247.47
            },
            {
              "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": 212.89
            },
            {
              "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": 339,
              "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": 247.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "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": 217.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 220.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 212.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217.64
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Ctf Std Wear 3/8 in- 3 1/2 in Assura Gray",
      "code_information": [
        {
          "code": "PX-CH-SW14309",
          "type": "CDM"
        },
        {
          "code": "A4415",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.64,
          "discounted_cash": 6.92,
          "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": 6.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.72
            },
            {
              "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": 2.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "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": 9.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 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": 6.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "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": 8.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.85
            },
            {
              "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": 6.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 5.85
            },
            {
              "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": 6.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 5.85
            },
            {
              "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": 7.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.98
            },
            {
              "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": 8.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 5.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 7.77
            },
            {
              "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": 6.83
            },
            {
              "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": 8.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.82
            },
            {
              "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": 6.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 6.72
            },
            {
              "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": 5.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "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": 8.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.64,
              "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": 10.64,
              "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": 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": 6.83
            },
            {
              "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": 6.83
            },
            {
              "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": 10.64,
              "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": 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": 6.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.85
            },
            {
              "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": 10.64,
              "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": 8.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 10.64,
              "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": 6.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.77
            },
            {
              "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": 9.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 7.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.91
            },
            {
              "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": 5.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 10.64,
              "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": 9.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.83
            },
            {
              "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": 8.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 10.64,
              "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": 9.04
            },
            {
              "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": 10.64,
              "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": 8.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 6.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 6.83
            },
            {
              "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": 6.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 10.64,
              "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": 9.04
            },
            {
              "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": 9.33
            },
            {
              "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": 10.64,
              "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": 7.98
            },
            {
              "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": 10.64,
              "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": 5.91
            },
            {
              "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": 6.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.64,
              "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": 10.64,
              "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": 8.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.77
            }
          ]
        }
      ]
    },
    {
      "description": "Absorption Dressing Exu-Dry 9 in X 15 In",
      "code_information": [
        {
          "code": "PX-CH-UN5999009",
          "type": "CDM"
        },
        {
          "code": "A6253",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.8,
          "discounted_cash": 5.07,
          "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": 5.01
            },
            {
              "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": 7.8,
              "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": 7.8,
              "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": 7.8,
              "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": 4.93
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.8,
              "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": 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": 5.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 7.8,
              "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": 7.8,
              "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": 5.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "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": 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": "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": 7.8,
              "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": 7.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 7.8,
              "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": 4.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.69
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 5.08
            },
            {
              "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": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 7.8,
              "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": 7.8,
              "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": 7.8,
              "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": 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": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 6.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 7.8,
              "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": 5.69
            },
            {
              "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": 7.8,
              "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": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 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": 4.33
            },
            {
              "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": 4.29
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 6.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.47
            },
            {
              "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": 5.01
            },
            {
              "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": 7.8,
              "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": 6.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.08
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.08
            },
            {
              "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": 4.33
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "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": 7.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "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": "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.8,
              "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": 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": 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": 6.84
            },
            {
              "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": 7.8,
              "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": 7.8,
              "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": 6.63
            },
            {
              "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": 4.93
            },
            {
              "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": "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": 7.8,
              "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": 6.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 7.8,
              "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": 5.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 4.93
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "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": 6.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 5.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 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": 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": 7.8,
              "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": 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": 6.31
            },
            {
              "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": 2.13
            },
            {
              "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": 7.8,
              "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": 4.33
            },
            {
              "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": 7.8,
              "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": 5.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.8,
              "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": 6.4
            },
            {
              "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": 6.47
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.8,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Wound Cleanser Dermagran 4 Oz",
      "code_information": [
        {
          "code": "PX-CH-DRWC-04",
          "type": "CDM"
        },
        {
          "code": "A6260",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.68,
          "discounted_cash": 2.39,
          "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": 2.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 3.13
            },
            {
              "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": 2.36
            },
            {
              "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": 2.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.69
            },
            {
              "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": 2.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 2.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.02
            },
            {
              "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": 2.36
            },
            {
              "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": 3.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 3.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.69
            },
            {
              "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": 2.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.02
            },
            {
              "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": 3.68,
              "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": 2.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.33
            },
            {
              "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": 3.68,
              "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": 2.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.13
            },
            {
              "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": 3.68,
              "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": 3.68,
              "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": 3.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.13
            },
            {
              "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": 3.68,
              "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": 2.33
            },
            {
              "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": 2.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 2.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 3.68,
              "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": 3.68,
              "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": 3.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.02
            },
            {
              "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": 2.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.04
            },
            {
              "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": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 2.69
            },
            {
              "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": 3.23
            },
            {
              "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": 2.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 3.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 3.68,
              "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": 3.68,
              "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": 2.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.76
            },
            {
              "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": 2.04
            },
            {
              "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": 2.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.36
            },
            {
              "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": 3.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.24
            },
            {
              "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": 3.13
            },
            {
              "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": 3.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 3.68,
              "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": 2.76
            },
            {
              "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
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.02
            },
            {
              "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": 2.02
            },
            {
              "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": 3.68,
              "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": 3.02
            },
            {
              "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": 2.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 2.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 2.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 2.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.68,
              "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": 3.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.68
            },
            {
              "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": 3.68,
              "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": 3.68,
              "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": 3.68,
              "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": 2.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tube Gastrostomy",
      "code_information": [
        {
          "code": "PX-27200028",
          "type": "CDM"
        },
        {
          "code": "27200028",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 176,
          "discounted_cash": 114.4,
          "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": 112.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "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": 176,
              "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": 132
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "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": 112.99
            },
            {
              "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": 144.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.9
            },
            {
              "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": 114.58
            },
            {
              "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": 112.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 48.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 114.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "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": 112.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 176
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 97.68
            },
            {
              "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": 97.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "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": 144.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 114.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "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": 154.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "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": 114.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "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": 112.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "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": 110.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 114.58
            },
            {
              "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": 142.38
            },
            {
              "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": 111.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "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": 110.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "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": 145.9
            },
            {
              "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": 96.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "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": 110.53
            },
            {
              "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": 154.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 114.22
            },
            {
              "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": 176,
              "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": 128.48
            },
            {
              "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": 176,
              "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": 149.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "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": 144.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "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": 176,
              "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": 112.99
            },
            {
              "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": 114.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 114.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 142.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "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": 111.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "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": 111.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "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": 149.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 110.53
            },
            {
              "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": 97.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "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": 128.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "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": 112.99
            },
            {
              "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": 154.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 176,
              "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": 97.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 114.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 114.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            }
          ]
        }
      ]
    },
    {
      "description": "Non-Adherent Drsg Impreg Strl 3 in X 8 in Cardinal",
      "code_information": [
        {
          "code": "PX-CH-55CWNM38",
          "type": "CDM"
        },
        {
          "code": "A6223",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.31,
          "discounted_cash": 0.85,
          "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": 0.84
            },
            {
              "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": 1.31,
              "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": 0.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.11
            },
            {
              "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": 1.31,
              "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": 1.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.31,
              "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": 1.31,
              "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": 0.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.72
            },
            {
              "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": 1.15
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.72
            },
            {
              "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": 1.31,
              "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": 1.31,
              "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": 1.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.98
            },
            {
              "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": 1.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.83
            },
            {
              "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": 1.31,
              "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": 1.31,
              "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": 1.11
            },
            {
              "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": 0.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.96
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.31,
              "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": 0.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.07
            },
            {
              "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": 1.31,
              "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": 0.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.72
            },
            {
              "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": 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": 1.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.11
            },
            {
              "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": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.31,
              "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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.31,
              "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": 0.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.96
            },
            {
              "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": 1.31,
              "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": 1.31,
              "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": 1.31,
              "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": 64.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.96
            },
            {
              "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": 1.31,
              "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": 1.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.98
            },
            {
              "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": 0.84
            },
            {
              "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": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.07
            },
            {
              "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": 1.31,
              "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": 1.31,
              "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": 0.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.31,
              "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": 1.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.11
            },
            {
              "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": 1.31,
              "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": 1.31,
              "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": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.31,
              "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": 1.31,
              "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": 1.31,
              "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": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.84
            },
            {
              "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": 1.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.11
            },
            {
              "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": 1.31,
              "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": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.31,
              "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": 1.07
            },
            {
              "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": 1.31,
              "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": 0.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.31,
              "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": 1.31,
              "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": 1.31,
              "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": 1.31,
              "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": 64.2,
              "estimated_amount": 0.84
            },
            {
              "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": 0.84
            },
            {
              "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": 1.31,
              "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": 1.31,
              "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": 1.11
            },
            {
              "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": 1.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.83
            },
            {
              "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": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.31,
              "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": 1.31,
              "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": 0.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 1.11
            },
            {
              "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": 1.31,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Vacuum Extractor",
      "code_information": [
        {
          "code": "PX-27200199",
          "type": "CDM"
        },
        {
          "code": "27200199",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 137,
          "discounted_cash": 89.05,
          "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": 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": 100.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "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": 76.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.95
            },
            {
              "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": 75.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 110.83
            },
            {
              "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": 116.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 88.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "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": 87.95
            },
            {
              "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": 110.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.04
            },
            {
              "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": 137,
              "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": 75.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137,
              "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": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.95
            },
            {
              "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": 87.95
            },
            {
              "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": 137,
              "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": 86.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 137
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.01
            },
            {
              "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": 116.45
            },
            {
              "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": 76.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.35
            },
            {
              "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": 137,
              "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": 86.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.35
            },
            {
              "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": 87.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.35
            },
            {
              "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": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.01
            },
            {
              "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": 86.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "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": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "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": 89.19
            },
            {
              "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": 137,
              "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": 112.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.34
            },
            {
              "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": 112.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.58
            },
            {
              "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": 86.04
            },
            {
              "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": 89.05
            },
            {
              "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": 120.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 88.91
            },
            {
              "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": 112.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.35
            },
            {
              "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": 100.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.19
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "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": 120.15
            },
            {
              "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": 120.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.45
            },
            {
              "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": 37.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.75
            },
            {
              "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": 76.04
            },
            {
              "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": 113.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 88.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 88.91
            },
            {
              "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": 89.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.95
            },
            {
              "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": 87.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.95
            },
            {
              "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": 112.34
            },
            {
              "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": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.19
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrogel Drsg Ag Silvasorb 4 in X 8 In",
      "code_information": [
        {
          "code": "PX-CH-MZMSC9348Z",
          "type": "CDM"
        },
        {
          "code": "A6243",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 53.59,
          "discounted_cash": 34.83,
          "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": 34.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 29.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 45.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.89
            },
            {
              "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": 14.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.4
            },
            {
              "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": 33.87
            },
            {
              "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": 39.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.55
            },
            {
              "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": 47.16
            },
            {
              "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": 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": 53.59,
              "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": 43.94
            },
            {
              "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": 45.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 53.59,
              "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": 34.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.12
            },
            {
              "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": 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": 29.74
            },
            {
              "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": 53.59,
              "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": 53.59,
              "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": 53.59,
              "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": 45.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.47
            },
            {
              "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": 34.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.4
            },
            {
              "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": 34.4
            },
            {
              "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": 29.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 45.55
            },
            {
              "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": 53.59,
              "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": 53.59,
              "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": 45.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.59,
              "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": 34.4
            },
            {
              "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": 34.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.94
            },
            {
              "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": 44.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.12
            },
            {
              "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": 33.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 45.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.47
            },
            {
              "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": 53.59,
              "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": 53.59,
              "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": 43.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 53.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.19
            },
            {
              "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": 45.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 53.59,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 34.4
            },
            {
              "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": 34.4
            },
            {
              "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": 43.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 33.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 43.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.12
            },
            {
              "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": 43.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "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": 39.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 34.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.89
            },
            {
              "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": 29.74
            },
            {
              "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": 34.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Genotype Dna Hepatitis B Sendout",
      "code_information": [
        {
          "code": "PX-30600320",
          "type": "CDM"
        },
        {
          "code": "87912",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1425,
          "discounted_cash": 926.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 890.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 260.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 220.84,
              "estimated_amount": 220.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "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": 890.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1168.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.25
            },
            {
              "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": 890.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 890.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 270.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 220.84,
              "estimated_amount": 220.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "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": 783.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1168.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1068.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 783.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 270.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 260.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "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": 890.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 890.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 344.55,
              "estimated_amount": 344.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1168.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 260.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 220.84,
              "estimated_amount": 220.84
            },
            {
              "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": 890.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 783.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1068.75
            },
            {
              "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": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1425
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 260.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 783.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 890.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "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": 1168.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 783.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 220.84,
              "estimated_amount": 220.84
            },
            {
              "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": 1168.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1168.5
            },
            {
              "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": 1254
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 270.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 783.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "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": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 257.45,
              "estimated_amount": 257.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 257.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 260.02,
              "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": 926.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 890.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 890.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            },
            {
              "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": 1168.5
            },
            {
              "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": 356.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 344.55,
              "estimated_amount": 344.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 783.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "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": 1211.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1425,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 287.34,
              "estimated_amount": 287.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 333.98,
              "estimated_amount": 333.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1068.75
            },
            {
              "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": 1211.25
            },
            {
              "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": 890.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 890.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1168.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 287.34,
              "estimated_amount": 287.34
            },
            {
              "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": 312.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 965.44,
              "estimated_amount": 965.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1211.25
            }
          ],
          "minimum": 220.84,
          "maximum": 965.44
        }
      ]
    },
    {
      "description": "Orthosis Ankle Foot W/Adj No Off the Shelf",
      "code_information": [
        {
          "code": "PX-27400036",
          "type": "CDM"
        },
        {
          "code": "L1930",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 810,
          "discounted_cash": 526.5,
          "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": 519.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 299.38,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 530.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 296.42,
              "estimated_amount": 296.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 296.42,
              "estimated_amount": 296.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 519.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 299.38,
              "additional_payer_notes": "DMEPOS 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": 655.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 664.2
            },
            {
              "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": 688.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 517.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 445.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 519.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 664.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 530.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "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": 810,
              "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": 810,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 311.24,
              "additional_payer_notes": "DMEPOS 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": 710.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 517.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 607.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 530.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 519.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 527.31
            },
            {
              "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": 810,
              "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": 449.55
            },
            {
              "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": 710.37
            },
            {
              "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": 526.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 445.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 591.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 445.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 591.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 296.42,
              "estimated_amount": 296.42
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 810,
              "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": 519.21
            },
            {
              "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": 519.21
            },
            {
              "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": 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": 530.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 810
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 607.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 530.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 530.55
            },
            {
              "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": 494.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 519.21
            },
            {
              "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": 64.1,
              "estimated_amount": 519.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 655.29
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 296.42,
              "estimated_amount": 296.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 517.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "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": 221.13
            },
            {
              "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": 530.55
            },
            {
              "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": 688.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 607.5
            },
            {
              "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": 449.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 445.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 519.21
            },
            {
              "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": 664.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "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": 664.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 311.24,
              "additional_payer_notes": "DMEPOS 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": 671.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 527.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 591.3
            },
            {
              "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": 671.49
            },
            {
              "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": 810,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 299.38,
              "additional_payer_notes": "DMEPOS 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": 527.31
            },
            {
              "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": 664.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 664.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 299.38,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 517.59
            },
            {
              "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": 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": 664.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 519.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 445.5
            },
            {
              "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": 530.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "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": 527.31
            },
            {
              "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": 527.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 445.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 449.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 311.24,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 296.42,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 299.38,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "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": 591.3
            },
            {
              "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": 810,
              "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": 591.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 688.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 296.42,
              "estimated_amount": 296.42
            },
            {
              "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": 449.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 296.42,
              "estimated_amount": 296.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 519.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 494.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 296.42,
              "estimated_amount": 296.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 591.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 664.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 671.49
            },
            {
              "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": 519.21
            }
          ],
          "minimum": 296.42,
          "maximum": 296.42
        }
      ]
    },
    {
      "description": "2 Pc Pouch Assura Closed Red - Closed",
      "code_information": [
        {
          "code": "PX-CH-SW14332",
          "type": "CDM"
        },
        {
          "code": "A4419",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.09,
          "discounted_cash": 2.01,
          "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": 1.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "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": 3.09,
              "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": 3.09,
              "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": 1.7
            },
            {
              "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": 1.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.26
            },
            {
              "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": 2.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            },
            {
              "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": 2.01
            },
            {
              "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": 0.84
            },
            {
              "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": 1.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.63
            },
            {
              "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": 2.63
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 1.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 1.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 1.71
            },
            {
              "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": 2.53
            },
            {
              "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": 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": 1.95
            },
            {
              "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": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 1.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 2.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 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": 2.26
            },
            {
              "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": 2.26
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.63
            },
            {
              "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": 2.63
            },
            {
              "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": 3.09,
              "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": 3.09,
              "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": 1.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 2.63
            },
            {
              "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": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.7
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.7
            },
            {
              "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": 2.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 1.98
            },
            {
              "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": 2.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "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": 2.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.09,
              "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": 1.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.32
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 2.63
            },
            {
              "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": 2.56
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "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": 1.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "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": 2.01
            },
            {
              "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": 2.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.32
            },
            {
              "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": 3.09,
              "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": 2.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            }
          ]
        }
      ]
    },
    {
      "description": "Gown Isolation White Impervious to Fluids",
      "code_information": [
        {
          "code": "PX-CH-DY2145",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.91,
          "discounted_cash": 0.59,
          "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": 0.58
            },
            {
              "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": 0.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.91,
              "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": 0.77
            },
            {
              "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.51
            },
            {
              "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "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": 0.91,
              "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": 0.5
            },
            {
              "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": 0.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.75
            },
            {
              "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 PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.58
            },
            {
              "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": 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": 0.58
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.66
            },
            {
              "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": "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": "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/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.75
            },
            {
              "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": 0.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.51
            },
            {
              "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": 0.8
            },
            {
              "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": 0.75
            },
            {
              "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": 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": 0.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.91,
              "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": 0.91,
              "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": 0.91,
              "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": 0.58
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.91,
              "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": 0.5
            },
            {
              "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": "AETNA [310]",
              "plan_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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "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": 0.74
            },
            {
              "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.91,
              "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": 0.91,
              "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": 0.75
            },
            {
              "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": 0.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 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": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.91,
              "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": 0.91,
              "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": 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": 0.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.91
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.66
            },
            {
              "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": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.91,
              "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": 0.58
            },
            {
              "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": 0.58
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "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": "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": 0.58
            },
            {
              "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": 0.59
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.75
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            }
          ]
        }
      ]
    },
    {
      "description": "Moisture Barrier Antifungal Ointment Aloe Vesta 5 Oz",
      "code_information": [
        {
          "code": "PX-CH-CV4018-93",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17.95,
          "discounted_cash": 11.67,
          "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": 11.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 17.95,
              "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": 14.88
            },
            {
              "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": 15.8
            },
            {
              "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": 17.95,
              "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": 17.95,
              "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": 63.2,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 11.52
            },
            {
              "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": 11.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.46
            },
            {
              "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": 17.95,
              "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": 15.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.72
            },
            {
              "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": 9.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.88
            },
            {
              "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": 17.95,
              "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": 11.69
            },
            {
              "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": 17.95,
              "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": 13.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.52
            },
            {
              "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": 4.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.26
            },
            {
              "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": 17.95,
              "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": 15.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.87
            },
            {
              "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": 14.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 17.95,
              "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": 15.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.87
            },
            {
              "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": 13.1
            },
            {
              "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": 11.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.34
            },
            {
              "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": 11.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 17.95,
              "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": 17.95,
              "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": 17.95,
              "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": 11.52
            },
            {
              "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": 15.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 17.95,
              "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": 14.72
            },
            {
              "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": 17.95,
              "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": 11.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 11.52
            },
            {
              "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": 11.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.26
            },
            {
              "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": 14.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.87
            },
            {
              "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": 14.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.72
            },
            {
              "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": 11.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.34
            },
            {
              "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": 15.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 15.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 9.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 14.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.46
            },
            {
              "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": 11.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 9.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 14.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.46
            },
            {
              "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": 9.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.1
            },
            {
              "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": 11.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14.52
            },
            {
              "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": 15.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 9.96
            },
            {
              "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": 15.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17.95,
              "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": 14.72
            }
          ]
        }
      ]
    },
    {
      "description": "HC Apligraf per Sq Cm",
      "code_information": [
        {
          "code": "PX-27800003",
          "type": "CDM"
        },
        {
          "code": "Q4101",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 94,
          "discounted_cash": 61.1,
          "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": 60.35
            },
            {
              "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": 77.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 94,
              "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": 82.72
            },
            {
              "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": 59.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 60.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "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": 94,
              "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": 94,
              "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": 77.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.41
            },
            {
              "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": 79.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 94,
              "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": 79.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.35
            },
            {
              "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": 61.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.19
            },
            {
              "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": 77.93
            },
            {
              "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": 59.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 94,
              "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": 77.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 94,
              "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": 94,
              "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": 60.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 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": 94,
              "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": 94,
              "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": 70.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.5
            },
            {
              "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": 60.35
            },
            {
              "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": 60.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 77.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 79.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "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": 94,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "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": 94,
              "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": 61.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 94,
              "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": 79.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "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": 51.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 94,
              "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": 94,
              "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": 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": 60.35
            },
            {
              "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": 68.62
            },
            {
              "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": 94,
              "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": 82.44
            },
            {
              "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": 94,
              "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": 94,
              "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": 94,
              "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": 77.08
            },
            {
              "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": 60.35
            },
            {
              "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": 61.19
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 94,
              "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": 79.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "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": 94,
              "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": 94,
              "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": 60.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "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": 79.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "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": 25.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 76.05
            },
            {
              "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": 94,
              "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": 59.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 94,
              "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": 51.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.41
            },
            {
              "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": 94,
              "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": 94,
              "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": 51.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "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": 94,
              "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": 94,
              "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": 76.05
            },
            {
              "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": 82.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "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": 60.35
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 94,
          "payers_information": [
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 94,
              "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": 94,
              "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": 94,
              "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": 94,
              "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": 94,
              "additional_payer_notes": "SRD"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Incubation of Serum W/Drugs Each",
      "code_information": [
        {
          "code": "PX-30000021",
          "type": "CDM"
        },
        {
          "code": "86975",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1190,
          "discounted_cash": 773.5,
          "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": 763.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 986.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.47,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 763.98
            },
            {
              "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": 324.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "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": 1047.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 892.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "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": 763.98
            },
            {
              "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": 975.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 654.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 660.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 654.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 763.98
            },
            {
              "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": 868.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 868.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 774.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "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": 654.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 654.5
            },
            {
              "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": 986.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 752.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 763.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 868.7
            },
            {
              "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": 1011.5
            },
            {
              "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": 1190,
              "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": 774.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 892.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 654.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "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": 975.8
            },
            {
              "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": 1190,
              "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": 975.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 752.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 752.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 763.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 774.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "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": 763.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 975.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "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": 660.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 763.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 868.7
            },
            {
              "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": 962.71
            },
            {
              "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": 1190,
              "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": 1043.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 654.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 868.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 962.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 975.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 975.8
            },
            {
              "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": 975.8
            },
            {
              "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": 752.08
            },
            {
              "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": 1011.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "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": 660.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 892.5
            },
            {
              "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": 752.08
            },
            {
              "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": 763.98
            },
            {
              "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": 763.98
            },
            {
              "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": 660.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 986.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 752.08
            },
            {
              "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": 773.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 975.8
            },
            {
              "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": 763.98
            },
            {
              "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": 774.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 868.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "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": 752.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1011.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 654.5
            },
            {
              "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": 1043.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.47,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 774.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 752.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1415.89,
              "estimated_amount": 1415.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1190
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 763.98
            }
          ],
          "minimum": 17.47,
          "maximum": 1415.89
        }
      ]
    },
    {
      "description": "HC Inhibition of Serum",
      "code_information": [
        {
          "code": "PX-30000023",
          "type": "CDM"
        },
        {
          "code": "86977",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 525,
          "discounted_cash": 341.25,
          "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": 337.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 383.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 383.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 288.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 337.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 341.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "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": 337.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 288.75
            },
            {
              "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": 291.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 331.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "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": 331.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 288.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 430.5
            },
            {
              "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": 341.78
            },
            {
              "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": 460.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 383.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "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": 460.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 288.75
            },
            {
              "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": 446.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 331.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 337.05
            },
            {
              "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": 291.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 337.05
            },
            {
              "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": 291.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 331.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "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": 525,
              "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": 393.75
            },
            {
              "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": 383.25
            },
            {
              "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": 462
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 525,
              "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": 337.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 331.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.47,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 288.75
            },
            {
              "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": 331.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 430.5
            },
            {
              "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": 430.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 430.5
            },
            {
              "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": 435.23
            },
            {
              "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": 446.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 393.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 430.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 383.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "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": 430.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 288.75
            },
            {
              "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": 331.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 337.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 288.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 525
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.47,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 341.78
            },
            {
              "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": 430.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 337.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 393.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 337.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 341.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 435.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 383.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 291.38
            },
            {
              "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": 337.05
            },
            {
              "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": 525,
              "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": 143.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 435.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 341.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 430.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 331.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 337.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 337.05
            },
            {
              "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": 424.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 446.25
            },
            {
              "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": 341.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 424.73
            }
          ],
          "minimum": 17.47,
          "maximum": 589.69
        }
      ]
    },
    {
      "description": "HC Sperm Antibody",
      "code_information": [
        {
          "code": "PX-30000043",
          "type": "CDM"
        },
        {
          "code": "89325",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 445,
          "discounted_cash": 289.25,
          "minimum": 5.35,
          "maximum": 40.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.5,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.5,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 324.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "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": 378.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 445,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 244.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 333.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.5,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 364.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.15,
              "estimated_amount": 9.15
            },
            {
              "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": 324.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "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": 244.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 244.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.35,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.78,
              "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": 333.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 324.85
            },
            {
              "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": 364.9
            },
            {
              "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": 289.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.15,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.15,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.78,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.78,
              "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": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 364.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 333.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 445,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.35,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 244.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.78,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "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": 378.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.2,
              "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": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "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": 111.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 364.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 445,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.85,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 445,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 244.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 244.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 324.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.15,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 324.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 364.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "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": 391.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 244.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 445
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 364.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.01,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 364.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 10.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.78,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 445,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": 445,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 445,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 324.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.85,
              "estimated_amount": 9.85
            },
            {
              "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": 364.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 378.25
            },
            {
              "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": 445,
              "additional_payer_notes": "Reference Lab"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 16 Fr 5 Cc",
      "code_information": [
        {
          "code": "PX-CH-BA123516A",
          "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 OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "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 OPTIONS [625335]",
              "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": "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.09
            },
            {
              "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": "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 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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "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": 1.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "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": 0.82
            },
            {
              "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": 1.28,
              "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": 1.28,
              "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": 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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN 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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "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": 1.28,
              "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": 1.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "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": 1.28,
              "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": "AETNA [310]",
              "plan_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": "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": "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": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "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": 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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "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 [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 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": "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": "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": "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 MANAGED MEDICARE [314]",
              "plan_name": "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": "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": "AVALON HEALTHREACH WV [540415]",
              "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "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": "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": "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": "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "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": 1.28,
              "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": 1.09
            },
            {
              "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": 0.81
            },
            {
              "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": 1.05
            },
            {
              "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": 0.35
            },
            {
              "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": "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": "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": "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": "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": "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 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 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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "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 PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 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": 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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "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": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "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": 1.28,
              "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": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "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": "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": "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 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": "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": "UNITEDHEALTHCARE 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": "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": "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "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": 1.12
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 2.13,
          "discounted_cash": 1.38,
          "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": 1.37
            },
            {
              "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": 1.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "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": 1.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "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": 2.13,
              "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": 2.13,
              "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": 1.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.39
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 1.81
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 2.13,
              "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": 1.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "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": 1.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.35
            },
            {
              "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": 2.13,
              "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": 1.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.35
            },
            {
              "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": 1.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "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": 1.55
            },
            {
              "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": 2.13,
              "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": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 1.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 1.72
            },
            {
              "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": 2.13,
              "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": 1.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "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": 1.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.75
            },
            {
              "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": 2.13,
              "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": 1.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 1.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.75
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "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": 2.13,
              "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": 1.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "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": 1.39
            },
            {
              "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": 1.75
            },
            {
              "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": 1.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.18
            },
            {
              "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": 1.39
            },
            {
              "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": 1.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.13,
              "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": 1.55
            },
            {
              "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": 1.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "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": 2.13,
              "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": 1.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.35
            },
            {
              "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": 1.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "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": 1.18
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 1.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "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": 2.13,
              "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": 1.35
            },
            {
              "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": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 8.17,
          "discounted_cash": 5.31,
          "payers_information": [
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.17,
              "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": 5.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.16
            },
            {
              "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": 4.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 8.17,
              "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": 5.32
            },
            {
              "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": 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": 6.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.96
            },
            {
              "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": 5.96
            },
            {
              "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": 8.17,
              "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": 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": 5.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.49
            },
            {
              "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": 7.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 8.17,
              "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": 6.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.94
            },
            {
              "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": 5.25
            },
            {
              "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": 6.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 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": 6.94
            },
            {
              "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": 2.23
            },
            {
              "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": 5.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.94
            },
            {
              "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": 8.17,
              "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": 6.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.17,
              "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": 5.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 8.17,
              "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": 8.17,
              "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": 8.17,
              "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": 8.17,
              "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": 8.17,
              "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": 8.17,
              "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": 6.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 8.17,
              "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": 7.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.32
            },
            {
              "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": 5.16
            },
            {
              "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": 6.77
            },
            {
              "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": 6.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 5.96
            },
            {
              "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": 6.94
            },
            {
              "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": 4.53
            },
            {
              "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": 8.17,
              "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": 5.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.17
            },
            {
              "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": 8.17,
              "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": 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": 6.7
            },
            {
              "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": 5.25
            },
            {
              "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": 5.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 4.53
            },
            {
              "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": 5.25
            },
            {
              "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": 4.49
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 4.49
            },
            {
              "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": 8.17,
              "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": 5.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 8.17,
              "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": 4.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 8.17,
              "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": 6.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.25
            },
            {
              "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": 8.17,
              "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": 6.61
            },
            {
              "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": 8.17,
              "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": 5.16
            },
            {
              "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": 7.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.16
            },
            {
              "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": 8.17,
              "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": 8.17,
              "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": 6.94
            },
            {
              "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": 5.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.7
            },
            {
              "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": 4.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.17,
              "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": 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": 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": 8.17,
              "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": 8.17,
              "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": 6.94
            },
            {
              "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": 8.17,
              "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": 8.17,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Sirolimus Sendout",
      "code_information": [
        {
          "code": "PX-30100038",
          "type": "CDM"
        },
        {
          "code": "80195",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41,
          "discounted_cash": 26.65,
          "minimum": 11.78,
          "maximum": 51.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 33.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "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": 33.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "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": 33.62
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.26,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.42,
              "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": 22.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "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": 20.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "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": 34.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "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": 18.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "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": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "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": 26.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.75
            },
            {
              "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": 18.45
            },
            {
              "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": 41,
              "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": 34.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "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": 20.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "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": 36.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.26,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "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": 41,
              "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": 34.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.26,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "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": 29.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.78,
              "estimated_amount": 11.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "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": 41,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.49,
              "estimated_amount": 51.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.73,
              "estimated_amount": 13.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "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": 10.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Calcium Urine 24 Hr",
      "code_information": [
        {
          "code": "PX-30100167",
          "type": "CDM"
        },
        {
          "code": "82340",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 87,
          "discounted_cash": 56.55,
          "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": 55.85
            },
            {
              "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": 56.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "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": 72.12
            },
            {
              "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": 73.95
            },
            {
              "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": 54.98
            },
            {
              "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": 71.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 87,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.09,
              "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": 73.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.82,
              "estimated_amount": 8.82
            },
            {
              "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": 71.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.98
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.09,
              "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": 6.03,
              "estimated_amount": 6.03
            },
            {
              "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": 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": 71.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.03,
              "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": 55.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.85
            },
            {
              "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": 55.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.03,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.51
            },
            {
              "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": 73.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 76.3
            },
            {
              "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": 76.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 48.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.82,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.51
            },
            {
              "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": 48.29
            },
            {
              "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": 70.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "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": 63.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.33,
              "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": 72.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.09,
              "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": 6.03,
              "estimated_amount": 6.03
            },
            {
              "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": 76.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.33,
              "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": 73.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.51
            },
            {
              "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": 54.98
            },
            {
              "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": 71.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 6.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.09,
              "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": 87,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "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": 48.29
            },
            {
              "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": 55.85
            },
            {
              "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": 56.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.85
            },
            {
              "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": 48.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "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": 23.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.03,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.98
            },
            {
              "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": 47.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 72.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.03,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.82,
              "estimated_amount": 8.82
            },
            {
              "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": 54.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 70.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.34
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.03,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.98
            },
            {
              "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": 87,
              "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": 55.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.61,
              "estimated_amount": 22.61
            },
            {
              "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": 56.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.85
            },
            {
              "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": 55.85
            }
          ],
          "minimum": 6.03,
          "maximum": 22.61
        }
      ]
    },
    {
      "description": "HC Cea",
      "code_information": [
        {
          "code": "PX-30100172",
          "type": "CDM"
        },
        {
          "code": "82378",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 149,
          "discounted_cash": 96.85,
          "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": 95.66
            },
            {
              "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": 108.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.26,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 67.05
            },
            {
              "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": 67.05
            },
            {
              "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": 95.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 149
            },
            {
              "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": 74.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "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": 122.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.26,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 67.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 67.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.15,
              "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": 149,
              "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": 111.75
            },
            {
              "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": 81.95
            },
            {
              "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": 122.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "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": 74.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "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": 96.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.15,
              "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": 95.66
            },
            {
              "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": 122.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.72,
              "estimated_amount": 27.72
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.72,
              "estimated_amount": 27.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "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": 95.66
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "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": 149,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.72,
              "estimated_amount": 27.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.26,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 67.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 67.05
            },
            {
              "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": 67.05
            },
            {
              "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": 95.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 25,
              "estimated_amount": 37.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.91,
              "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": 81.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.15,
              "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": 74.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.26,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.18
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.91,
              "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": 111.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 67.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "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": 126.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "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": 131.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.77
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            },
            {
              "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": 95.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "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": 126.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 18.96,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.15,
              "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": 95.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.77
            },
            {
              "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": 149,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 67.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74.5
            },
            {
              "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": 67.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 71.1,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.96,
              "estimated_amount": 18.96
            },
            {
              "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": 126.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.65
            }
          ],
          "minimum": 16.26,
          "maximum": 71.1
        }
      ]
    },
    {
      "description": "Carotene Sendout",
      "code_information": [
        {
          "code": "PX-30100174",
          "type": "CDM"
        },
        {
          "code": "82380",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 508,
          "discounted_cash": 330.2,
          "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": 326.14
            },
            {
              "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": 330.71
            },
            {
              "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": 321.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.48,
              "estimated_amount": 13.48
            },
            {
              "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": 281.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.4
            },
            {
              "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": 431.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 326.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "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": 447.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.22,
              "estimated_amount": 9.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 321.06
            },
            {
              "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": 326.14
            },
            {
              "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": 410.97
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.68,
              "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": 416.56
            },
            {
              "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": 416.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.22,
              "estimated_amount": 9.22
            },
            {
              "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": 326.14
            },
            {
              "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": 326.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 330.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 326.14
            },
            {
              "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": 326.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 381
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "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": 326.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 330.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 381
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.68,
              "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": 321.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 326.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.22,
              "estimated_amount": 9.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.48,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 410.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "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": 445.52
            },
            {
              "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": 279.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 321.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 508
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 370.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 321.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 281.94
            },
            {
              "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": 416.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.22,
              "estimated_amount": 9.22
            },
            {
              "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": 370.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.22,
              "estimated_amount": 9.22
            },
            {
              "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": 421.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "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": 416.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 370.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 370.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 421.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.22,
              "estimated_amount": 9.22
            },
            {
              "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": 330.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "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": 281.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.31,
              "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": 431.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 326.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.22,
              "estimated_amount": 9.22
            },
            {
              "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": 445.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.58,
              "estimated_amount": 34.58
            },
            {
              "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": 321.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "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": 330.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 416.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 416.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 321.06
            },
            {
              "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": 321.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 370.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.31,
              "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": 326.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 326.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 330.71
            },
            {
              "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": 138.68
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 9.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.68,
              "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": 421.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.48,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 370.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 416.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 416.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 381
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 281.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 431.8
            }
          ],
          "minimum": 9.22,
          "maximum": 34.58
        }
      ]
    },
    {
      "description": "HC Chloride Blood",
      "code_information": [
        {
          "code": "PX-30100181",
          "type": "CDM"
        },
        {
          "code": "82435",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "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": 5.78
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": 7.92
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "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 HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 7.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": 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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 5.69
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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 PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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 PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "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": 2.46
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "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": "UHC 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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.83,
              "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": 7.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 5.78
            },
            {
              "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": 5.78
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 5.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.83,
              "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": 7.65
            },
            {
              "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": "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 OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "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": 5.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": "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": "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 [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "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": "HUMANA [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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "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": "MOLINA 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": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "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": 7.38
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 5.69
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "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": "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 AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 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": "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": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "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": 9,
              "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": 5.69
            }
          ],
          "minimum": 4.6,
          "maximum": 17.25
        }
      ]
    },
    {
      "description": "Nutritional Boost Chocolate 8oz",
      "code_information": [
        {
          "code": "PX-CH-BUR-67539",
          "type": "CDM"
        },
        {
          "code": "B4150",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.39,
          "discounted_cash": 1.55,
          "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": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "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": 1.31
            },
            {
              "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 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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.31
            },
            {
              "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": 1.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "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": 2.03
            },
            {
              "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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.39,
              "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": 1.51
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "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": "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 PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.93
            },
            {
              "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "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": 2.03
            },
            {
              "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": 1.51
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "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": 2.39,
              "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": 2.39,
              "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": 2.03
            },
            {
              "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": 2.39,
              "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": 1.55
            },
            {
              "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": "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": "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "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": 1.96
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.79
            },
            {
              "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": 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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.56
            },
            {
              "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": 1.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.96
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": "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": "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": "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/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": "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 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": "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": "BUCKEYE COMMUNITY 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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "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": 2.1
            },
            {
              "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.93
            },
            {
              "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": 1.96
            },
            {
              "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": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "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": "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": "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": "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.39,
              "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": 1.51
            },
            {
              "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": 1.51
            },
            {
              "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": 1.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 2.39,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Sponge Sterile 3 in X 3 in 2 Fts",
      "code_information": [
        {
          "code": "PX-CH-KN1903",
          "type": "CDM"
        },
        {
          "code": "A6402",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.07,
          "discounted_cash": 0.05,
          "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": 0.04
            },
            {
              "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": "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 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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.07,
              "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": 0.04
            },
            {
              "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"
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.06
            },
            {
              "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": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "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 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/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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.07,
              "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": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.05
            },
            {
              "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": 0.07,
              "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": 0.07,
              "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": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "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": 0.07,
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.05
            },
            {
              "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": 0.04
            },
            {
              "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": "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.07
            },
            {
              "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": 0.05
            },
            {
              "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": 0.07,
              "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": 0.06
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.07,
              "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": 0.07,
              "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": 0.06
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.07,
              "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": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "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": 0.06
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.07,
              "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": 0.07,
              "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": 64.2,
              "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": "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": "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": "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": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "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": 0.07,
              "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": 0.07,
              "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": 0.05
            },
            {
              "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": 0.06
            },
            {
              "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": 0.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.07,
              "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": 0.07,
              "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": 0.06
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "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": "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": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.04
            },
            {
              "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": 0.05
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "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": 0.07,
              "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": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "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": "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": "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": 0.07,
              "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": 0.04
            },
            {
              "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": 0.07,
              "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": 0.05
            },
            {
              "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": 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": 0.04
            },
            {
              "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": "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": "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": "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": "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": "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": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.04
            },
            {
              "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": 0.04
            },
            {
              "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.07,
              "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": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "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": 0.07,
              "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": 0.06
            },
            {
              "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": 0.06
            },
            {
              "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": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fructose Semen Sendout",
      "code_information": [
        {
          "code": "PX-30100246",
          "type": "CDM"
        },
        {
          "code": "82757",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 310,
          "discounted_cash": 201.5,
          "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": 199.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 310
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 232.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 195.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "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": 84.63
            },
            {
              "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": 310,
              "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": 232.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "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": 254.2
            },
            {
              "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": 272.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 226.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "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": 172.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.34,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.34,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 254.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "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": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "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": 310,
              "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": 201.81
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 226.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "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": 250.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "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": 263.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 226.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 256.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "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": 201.81
            },
            {
              "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": 201.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 199.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 226.3
            },
            {
              "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": 201.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 201.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 172.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 256.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 256.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 250.79
            },
            {
              "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": 271.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "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": 172.05
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "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": 271.87
            },
            {
              "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": 195.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 254.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.03,
              "estimated_amount": 65.03
            },
            {
              "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": 172.05
            },
            {
              "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": 226.3
            },
            {
              "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": 263.5
            },
            {
              "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": 310,
              "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": 195.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "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": 254.2
            },
            {
              "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": 170.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "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": 199.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 263.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 170.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 201.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 232.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 226.3
            }
          ],
          "minimum": 3.34,
          "maximum": 65.03
        }
      ]
    },
    {
      "description": "HC Glucose Tolerance Addl Specimen",
      "code_information": [
        {
          "code": "PX-30100264",
          "type": "CDM"
        },
        {
          "code": "82952",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 45,
          "discounted_cash": 29.25,
          "minimum": 3.13,
          "maximum": 14.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "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": 22.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "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": 36.9
            },
            {
              "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": 38.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.92,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "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": 36.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "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": 45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.96,
              "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": 45,
              "estimated_amount": 20.25
            },
            {
              "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": 20.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "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": 22.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "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": 20.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.12,
              "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": 45
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.57,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.57,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.92,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.13,
              "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": 24.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.13,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.92,
              "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": 29.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.57,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "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": 45,
              "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": 38.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.13,
              "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": 45,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.75
            },
            {
              "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": 32.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 3.92,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.92,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.92,
              "estimated_amount": 3.92
            },
            {
              "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": 11.25
            },
            {
              "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": 38.25
            },
            {
              "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": 45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.68,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.13,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "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": 39.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.7,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.92,
              "estimated_amount": 3.92
            },
            {
              "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": 36.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.92,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsh",
      "code_information": [
        {
          "code": "PX-30100271",
          "type": "CDM"
        },
        {
          "code": "83001",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39,
          "discounted_cash": 25.35,
          "minimum": 15.27,
          "maximum": 69.68,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "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": 33.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.27,
              "estimated_amount": 15.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "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": 19.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.58,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.58,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.51,
              "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": 33.15
            },
            {
              "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": 17.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.58,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "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": 17.55
            },
            {
              "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": 39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.16,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "UHC 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "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": 21.45
            },
            {
              "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": 17.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.16,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.77,
              "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": 33.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.58,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.16,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 31.98
            },
            {
              "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": 9.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.58,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "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": 19.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.77,
              "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": 39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "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": 34.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.27,
              "estimated_amount": 15.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.58,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "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": 25.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.27,
              "estimated_amount": 15.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.27,
              "estimated_amount": 15.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.58,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 18.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.51,
              "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": 45,
              "estimated_amount": 17.55
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69.68,
              "estimated_amount": 69.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 28.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.55,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            }
          ]
        }
      ]
    },
    {
      "description": "HC Immunoassay Noninfectious Agent",
      "code_information": [
        {
          "code": "PX-30100295",
          "type": "CDM"
        },
        {
          "code": "83516",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 318,
          "discounted_cash": 206.7,
          "minimum": 9.48,
          "maximum": 43.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "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": 260.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 232.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.86,
              "estimated_amount": 16.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.48,
              "estimated_amount": 9.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 143.1
            },
            {
              "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": 279.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 318,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "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": 174.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 318,
              "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": 270.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "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": 174.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 238.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 206.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "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": 270.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 232.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "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": 318,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 143.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 143.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 232.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 143.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 143.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 143.1
            },
            {
              "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": 260.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "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": 260.76
            },
            {
              "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": 270.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.76
            },
            {
              "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": 143.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 159
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 159
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 232.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "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": 143.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.48,
              "estimated_amount": 9.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 159
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 318
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 232.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.48,
              "estimated_amount": 9.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.86,
              "estimated_amount": 16.86
            },
            {
              "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": 143.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 232.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.86,
              "estimated_amount": 16.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "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": 270.3
            },
            {
              "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": 79.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 238.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 238.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.11,
              "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": 260.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 143.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.48,
              "estimated_amount": 9.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Lactic Acid Lactate",
      "code_information": [
        {
          "code": "PX-30100305",
          "type": "CDM"
        },
        {
          "code": "83605",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 79,
          "discounted_cash": 51.35,
          "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": 50.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 51.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 43.85
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "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": 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": 49.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 64.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 67.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 50.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 64.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 79,
              "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": 49.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "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": 21.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 51.43
            },
            {
              "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": 51.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 67.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 43.85
            },
            {
              "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": 69.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "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": 69.52
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 50.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "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": 63.91
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 67.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "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": 67.15
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "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": 49.93
            },
            {
              "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": 43.45
            },
            {
              "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": 79,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 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": 59.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 69.28
            },
            {
              "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": 49.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 57.67
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            }
          ],
          "minimum": 11.57,
          "maximum": 43.39
        }
      ]
    },
    {
      "description": "Slipper Socks Large Blue",
      "code_information": [
        {
          "code": "PX-CH-DY2182",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.06,
          "discounted_cash": 0.69,
          "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": 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": 0.67
            },
            {
              "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": 1.06,
              "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": 0.9
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.86
            },
            {
              "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": 0.87
            },
            {
              "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 [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": "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": "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 [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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.8
            },
            {
              "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": 0.67
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.77
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "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": "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.86
            },
            {
              "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": "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.69
            },
            {
              "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": 1.06,
              "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": 1.06,
              "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": 0.9
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "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": "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": "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": "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "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": 0.69
            },
            {
              "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": "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 OPEN ACCESS MANAGED CHOICE [310201]",
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.77
            },
            {
              "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": "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 [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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "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": 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": 0.93
            },
            {
              "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "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": 0.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "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": 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": 0.9
            },
            {
              "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": 0.88
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 1.06,
              "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": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "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": "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"
            }
          ]
        }
      ]
    },
    {
      "description": "Huber Infusion Set Plus 19 G X 1 1/2 in Safety",
      "code_information": [
        {
          "code": "PX-CH-FEMM1915",
          "type": "CDM"
        },
        {
          "code": "A4212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22.74,
          "discounted_cash": 14.78,
          "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": 14.6
            },
            {
              "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": 14.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "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": 20.01
            },
            {
              "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": 18.85
            },
            {
              "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": 19.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "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": 19.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.6
            },
            {
              "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": 19.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.8
            },
            {
              "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": 18.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 14.37
            },
            {
              "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": 14.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 14.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.6
            },
            {
              "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": 18.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.06
            },
            {
              "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": 22.74,
              "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": 22.74,
              "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": 22.74,
              "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": 22.74,
              "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": 22.74,
              "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": 14.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.37
            },
            {
              "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": 14.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 19.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "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": 18.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.6
            },
            {
              "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": 14.8
            },
            {
              "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": 22.74,
              "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": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 19.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "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": 19.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 12.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.6
            },
            {
              "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": 22.74,
              "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": 18.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.6
            },
            {
              "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": 14.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.33
            },
            {
              "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": 14.6
            },
            {
              "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": 14.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 22.74,
              "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": 22.74,
              "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": 22.74,
              "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": 22.74,
              "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": 16.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 19.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 16.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.85
            },
            {
              "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": 12.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.33
            },
            {
              "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": 14.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 12.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 12.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.74,
              "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": 6.21
            },
            {
              "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": 22.74,
              "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": 16.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cholesterol Vldl Chylomicrons",
      "code_information": [
        {
          "code": "PX-30100322",
          "type": "CDM"
        },
        {
          "code": "83719",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 77,
          "discounted_cash": 50.05,
          "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": 49.43
            },
            {
              "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": 63.14
            },
            {
              "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": 56.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "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": 67.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 42.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.75
            },
            {
              "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": 63.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 63.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "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": 67.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "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": 65.45
            },
            {
              "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": 77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "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": 65.45
            },
            {
              "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": 77,
              "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": 50.13
            },
            {
              "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": 50.05
            },
            {
              "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": 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": 50.13
            },
            {
              "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": 49.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.13
            },
            {
              "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": 49.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "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": 48.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "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": 63.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "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": 67.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "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": 42.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "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": 63.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.13
            },
            {
              "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": 49.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "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": 42.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "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": 48.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 63.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.13
            },
            {
              "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": 21.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "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": 42.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "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": 77,
              "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": 49.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.43
            },
            {
              "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": 49.43
            },
            {
              "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": 48.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.81,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "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": 42.74
            }
          ],
          "minimum": 17,
          "maximum": 47.81
        }
      ]
    },
    {
      "description": "Vitamin B 2 Riboflavin Sendout",
      "code_information": [
        {
          "code": "PX-30100403",
          "type": "CDM"
        },
        {
          "code": "84252",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 118,
          "discounted_cash": 76.7,
          "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": 75.76
            },
            {
              "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": 75.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.24,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.56,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.24,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.44,
              "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": 65.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.24,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 118
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.82
            },
            {
              "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": 75.76
            },
            {
              "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": 103.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 97.82
            },
            {
              "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": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "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": 118,
              "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": 75.76
            },
            {
              "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": 75.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 103.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.24,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.56,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "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": 75.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "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": 96.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 97.82
            },
            {
              "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": 86.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.25,
              "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": 65.49
            },
            {
              "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": 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": 95.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "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": 76.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 95.46
            },
            {
              "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": 100.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "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": 103.49
            },
            {
              "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": 76.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.44,
              "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": 96.76
            },
            {
              "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": 96.76
            },
            {
              "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": 97.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 75.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "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": 118,
              "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": 100.3
            },
            {
              "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": 118,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.24,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "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": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.82
            },
            {
              "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": 96.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "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": 64.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.5
            },
            {
              "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": 100.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.24,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "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": 32.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.44,
              "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": 100.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.24,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.9,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 76.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.56,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 20.24,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 20.24,
          "maximum": 75.9
        }
      ]
    },
    {
      "description": "Thyroid Stimulating Immunoglob Sendout",
      "code_information": [
        {
          "code": "PX-30100428",
          "type": "CDM"
        },
        {
          "code": "84445",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 148,
          "discounted_cash": 96.2,
          "minimum": 23.95,
          "maximum": 190.73,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 53.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 121.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 53.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.62,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 51.37,
              "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": 121.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "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": 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": 108.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 66.6
            },
            {
              "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": 66.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.86,
              "estimated_amount": 50.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.62,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 74.31,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 121.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 66.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 148
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "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": 108.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.86,
              "estimated_amount": 50.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 51.37,
              "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": 121.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 51.37,
              "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": 45,
              "estimated_amount": 66.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 81.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 51.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.62,
              "estimated_amount": 43.62
            },
            {
              "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": 121.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "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": 125.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 148,
              "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": 125.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.86,
              "estimated_amount": 50.86
            },
            {
              "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": 66.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "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": 74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 66.6
            },
            {
              "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": 96.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 66.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 66.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.86,
              "estimated_amount": 50.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 53.4,
              "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": 125.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "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": 148,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 74.31,
              "estimated_amount": 74.31
            },
            {
              "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": 125.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.86,
              "estimated_amount": 50.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.86,
              "estimated_amount": 50.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "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": 37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 66.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "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": 148,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.86,
              "estimated_amount": 50.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 50.86,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 51.37,
              "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": 125.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 66.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.95,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.62,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 130.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 190.73,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 74
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 74.31,
              "estimated_amount": 74.31
            }
          ]
        }
      ]
    },
    {
      "description": "Vitamin E Sendout",
      "code_information": [
        {
          "code": "PX-30100429",
          "type": "CDM"
        },
        {
          "code": "84446",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43,
          "discounted_cash": 27.95,
          "minimum": 12.16,
          "maximum": 53.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "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": 35.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.89,
              "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": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.72,
              "estimated_amount": 20.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "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": 23.65
            },
            {
              "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": 35.26
            },
            {
              "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": 19.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 45,
              "estimated_amount": 19.35
            },
            {
              "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": 27.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.89,
              "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": 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": 35.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.32,
              "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": 36.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "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": 10.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.16,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.72,
              "estimated_amount": 20.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "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": 21.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "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": 35.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.16,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.16,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.89,
              "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": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.72,
              "estimated_amount": 20.72
            },
            {
              "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": 43,
              "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": 23.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "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": 31.39
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "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": 21.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "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": 19.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.32,
              "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": 36.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 14.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.32,
              "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": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "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": 43,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.16,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "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": 43,
              "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": 21.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "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": 36.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "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": 37.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 21.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.36,
              "estimated_amount": 12.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 53.18,
              "estimated_amount": 53.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.55
            }
          ]
        }
      ]
    },
    {
      "description": "Oxcarbazepine Trileptal Sendout",
      "code_information": [
        {
          "code": "PX-30100533",
          "type": "CDM"
        },
        {
          "code": "80183",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 52,
          "discounted_cash": 33.8,
          "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": 32.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.38,
              "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": 62.5,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.36,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.38,
              "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": 52,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 32.5
            },
            {
              "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": 42.64
            },
            {
              "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": 52,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "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": 28.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.25,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.25,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.36,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 37.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.38,
              "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": 52
            },
            {
              "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": 32.5
            },
            {
              "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": 13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.25,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.74,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.74,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "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": 23.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 44.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.25,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.36,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.25,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "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": 44.2
            },
            {
              "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": 42.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "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": 45.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.25,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "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": 37.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.36,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "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": 42.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.64
            },
            {
              "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": 52,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 32.5
            },
            {
              "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": 33.8
            },
            {
              "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": 26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26
            },
            {
              "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": 26
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.25,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 45,
              "estimated_amount": 23.4
            },
            {
              "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": 23.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.38,
              "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": 62.5,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.74,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 62.5,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.6
            },
            {
              "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": 32.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.69,
              "estimated_amount": 49.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.2
            }
          ],
          "minimum": 11.36,
          "maximum": 49.69
        }
      ]
    },
    {
      "description": "HC Alcohols So",
      "code_information": [
        {
          "code": "PX-30100581",
          "type": "CDM"
        },
        {
          "code": "80320",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 118,
          "discounted_cash": 76.7,
          "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": 75.76
            },
            {
              "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": 74.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 86.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 118,
              "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": 118,
              "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": 76.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.07,
              "estimated_amount": 16.07
            },
            {
              "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": 118,
              "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": 88.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "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": 96.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 76.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 65.49
            },
            {
              "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": 100.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 97.82
            },
            {
              "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": 76.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "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": 118,
              "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": 75.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 74.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "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": 75.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "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": 100.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 95.46
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 64.9
            },
            {
              "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": 86.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.07,
              "estimated_amount": 16.07
            },
            {
              "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": 74.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.07,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 103.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "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": 96.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 75.76
            },
            {
              "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": 75.76
            },
            {
              "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": 96.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 97.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 75.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 118,
              "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": 118,
              "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": 64.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.5
            },
            {
              "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": 118,
              "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": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 118,
              "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": 100.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 103.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.3
            },
            {
              "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": 75.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.76
            },
            {
              "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": 65.49
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "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": 103.49
            },
            {
              "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": 75.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 64.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 100.3
            },
            {
              "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": 97.82
            },
            {
              "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": 95.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 118,
              "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": 118
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.76
            },
            {
              "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": 32.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.58
            }
          ],
          "minimum": 16.07,
          "maximum": 16.07
        }
      ]
    },
    {
      "description": "Gloves Nitrile Powder Free Sterile Large",
      "code_information": [
        {
          "code": "PX-CH-MZAKW7826",
          "type": "CDM"
        },
        {
          "code": "A4930",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.42,
          "discounted_cash": 0.27,
          "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": 0.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.34
            },
            {
              "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": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.36
            },
            {
              "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": 0.36
            },
            {
              "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": 0.42,
              "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": 0.42,
              "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": 0.27
            },
            {
              "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": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.42,
              "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": 0.23
            },
            {
              "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": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.42,
              "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": 0.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.42
            },
            {
              "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": 0.42,
              "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": 0.27
            },
            {
              "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": 0.34
            },
            {
              "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": 0.23
            },
            {
              "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": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.42,
              "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": 0.36
            },
            {
              "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": 0.23
            },
            {
              "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": 0.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.23
            },
            {
              "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": 0.42,
              "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": 0.27
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.42,
              "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": 0.27
            },
            {
              "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": 0.37
            },
            {
              "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": 0.42,
              "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": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.27
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.27
            },
            {
              "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": 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": 0.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "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": 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": 0.42,
              "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": 0.42,
              "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": 0.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.42,
              "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": 0.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.34
            },
            {
              "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": 0.31
            },
            {
              "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": 0.42,
              "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": 0.42,
              "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": 0.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.36
            },
            {
              "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": 0.42,
              "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": 0.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.27
            },
            {
              "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": 0.23
            },
            {
              "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": 0.42,
              "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": 0.23
            },
            {
              "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": 0.42,
              "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": 0.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.42,
              "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": 0.42,
              "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": 0.42,
              "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": 0.37
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.36
            },
            {
              "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": 0.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.34
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.27
            },
            {
              "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": 0.42,
              "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": 0.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.42,
              "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": 0.42,
              "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": 0.42,
              "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": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.35
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.42,
              "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": 0.31
            },
            {
              "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": 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": 0.27
            },
            {
              "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": 0.27
            },
            {
              "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": 0.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "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": 0.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Suction Catheter 14 Fr With Control Port",
      "code_information": [
        {
          "code": "PX-CH-PHT60C",
          "type": "CDM"
        },
        {
          "code": "A4624",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.96,
          "discounted_cash": 0.62,
          "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": 0.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.53
            },
            {
              "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": 0.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.96,
              "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": 0.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.62
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.96,
              "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": 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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.96,
              "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": 0.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.62
            },
            {
              "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": 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": 0.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.72
            },
            {
              "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": 0.7
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.8
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.79
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.72
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.79
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.53
            },
            {
              "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": 0.96,
              "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": 0.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.96,
              "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": 0.26
            },
            {
              "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": 0.61
            },
            {
              "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": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.8
            },
            {
              "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": 0.96,
              "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": 0.61
            },
            {
              "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": 0.96,
              "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": 0.96,
              "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": 0.7
            },
            {
              "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": 0.96,
              "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": 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": 0.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.96,
              "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": 0.96,
              "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": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.82
            },
            {
              "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": 0.96,
              "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": 0.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.7
            },
            {
              "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": 0.62
            },
            {
              "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": 0.61
            },
            {
              "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": 0.84
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Attends Breathable Extra Small/Youth",
      "code_information": [
        {
          "code": "PX-CH-AHPBRBX10",
          "type": "CDM"
        },
        {
          "code": "A4520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.98,
          "discounted_cash": 0.64,
          "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": 0.63
            },
            {
              "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": 0.8
            },
            {
              "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": 0.98,
              "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": 0.98,
              "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": 0.83
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.64
            },
            {
              "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": 0.98,
              "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": 0.98,
              "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": 0.98,
              "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": 0.83
            },
            {
              "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": 0.98,
              "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": 0.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.54
            },
            {
              "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": 0.63
            },
            {
              "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": 0.86
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "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": 0.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.98,
              "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": 0.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "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": 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": 0.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.54
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.83
            },
            {
              "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": 0.63
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "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": 0.98,
              "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": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.72
            },
            {
              "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": 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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.74
            },
            {
              "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": 0.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.63
            },
            {
              "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": 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": 0.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.54
            },
            {
              "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": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.63
            }
          ]
        }
      ]
    },
    {
      "description": "HC D Lactate So",
      "code_information": [
        {
          "code": "PX-30100790",
          "type": "CDM"
        },
        {
          "code": "83605",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 182,
          "discounted_cash": 118.3,
          "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": 116.84
            },
            {
              "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": 147.24
            },
            {
              "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": 115.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "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": 118.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "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": 115.02
            },
            {
              "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": 149.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 116.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 115.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "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": 116.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 115.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 101.01
            },
            {
              "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": 49.69
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "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": 154.7
            },
            {
              "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": 160.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 136.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 182
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 182,
              "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": 136.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.24
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 132.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 101.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.1
            },
            {
              "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": 116.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 182,
              "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": 154.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 154.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 150.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.48
            },
            {
              "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": 149.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 136.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "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": 149.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 150.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 150.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 118.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 182,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 154.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.24
            },
            {
              "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": 159.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 116.84
            },
            {
              "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": 116.84
            },
            {
              "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": 118.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 115.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.1
            },
            {
              "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": 159.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 100.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.86
            },
            {
              "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": 101.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 115.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 101.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 147.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 115.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 115.02
            },
            {
              "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": 132.86
            }
          ],
          "minimum": 11.57,
          "maximum": 43.39
        }
      ]
    },
    {
      "description": "Drainage Bag 2000ml Bedside Anti-Reflux Valve Lf",
      "code_information": [
        {
          "code": "PX-CH-KN6208",
          "type": "CDM"
        },
        {
          "code": "A4357",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.61,
          "discounted_cash": 4.95,
          "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": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 7.61,
              "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": 6.31
            },
            {
              "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": 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": 6.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.47
            },
            {
              "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": 4.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.81
            },
            {
              "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": 4.22
            },
            {
              "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": 7.61,
              "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 fee schedule.",
              "estimated_amount": 7.61,
              "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": 6.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 4.89
            },
            {
              "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": 2.08
            },
            {
              "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": 7.61,
              "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": 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": 5.71
            },
            {
              "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": 7.61,
              "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": 4.19
            },
            {
              "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": 7.61,
              "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": 4.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 5.56
            },
            {
              "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": 7.61,
              "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": 4.89
            },
            {
              "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": 4.89
            },
            {
              "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": 7.61,
              "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": 7.61,
              "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": 6.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.81
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.47
            },
            {
              "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": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 4.19
            },
            {
              "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": 5.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.61
            },
            {
              "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": 4.22
            },
            {
              "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": 6.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 6.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 7.61,
              "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": 7.61,
              "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": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.24
            },
            {
              "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": 7.61,
              "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": 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": 6.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 6.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.71
            },
            {
              "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": 4.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.56
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 4.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 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": 4.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 7.61,
              "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": 6.7
            },
            {
              "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": 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": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.61,
              "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": 7.61,
              "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": 7.61,
              "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": 6.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 6.47
            },
            {
              "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": 4.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 4.95
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.61,
              "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": 5.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 4.95
            },
            {
              "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": 7.61,
              "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": 4.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.47
            },
            {
              "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": 4.89
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.61,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Antistreptolysin O Titer",
      "code_information": [
        {
          "code": "PX-30200009",
          "type": "CDM"
        },
        {
          "code": "86060",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 32,
          "discounted_cash": 20.8,
          "minimum": 6.25,
          "maximum": 27.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.3,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.36
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.3,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.3,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "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": 28.16
            },
            {
              "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": 32,
              "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": 23.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "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": 27.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.25,
              "estimated_amount": 6.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 23.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.3,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.67,
              "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": 26.24
            },
            {
              "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": 17.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "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": 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": 20.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "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": 14.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.6
            },
            {
              "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": 32,
              "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": 23.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.37,
              "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": 27.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.37,
              "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": 27.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "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": 26.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.3,
              "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": 27.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.25,
              "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": 26.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.3,
              "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": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.3,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "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": 26.24
            },
            {
              "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": 14.4
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.67,
              "estimated_amount": 10.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.37,
              "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": 32,
              "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": 45,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.25,
              "estimated_amount": 6.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.25,
              "estimated_amount": 6.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 7.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.38,
              "estimated_amount": 27.38
            },
            {
              "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": 26.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 14.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC C Reactive Protein Cardiac Risk",
      "code_information": [
        {
          "code": "PX-30200012",
          "type": "CDM"
        },
        {
          "code": "86141",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 38,
          "discounted_cash": 24.7,
          "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": 24.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "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": 38,
              "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": 31.5
            },
            {
              "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": 24.02
            },
            {
              "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": 24.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "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": 24.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "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": 31.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "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": 24.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.91,
              "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": 20.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.95,
              "estimated_amount": 12.95
            },
            {
              "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": 21.09
            },
            {
              "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": 31.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.4
            },
            {
              "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": 24.74
            },
            {
              "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": 31.16
            },
            {
              "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": 30.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.95,
              "estimated_amount": 12.95
            },
            {
              "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": 32.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.6,
              "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": 31.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.95,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.08,
              "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": 24.02
            },
            {
              "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": 24.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "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": 38,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "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": 33.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.6,
              "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": 31.16
            },
            {
              "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": 20.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.08,
              "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": 38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.95,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.91,
              "estimated_amount": 18.91
            },
            {
              "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": 33.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.95,
              "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": 24.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.74
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.6,
              "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": 24.4
            },
            {
              "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": 24.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "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": 21.09
            },
            {
              "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": 24.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "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": 38,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.4
            },
            {
              "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": 24.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.16
            },
            {
              "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": 10.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.95,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.91,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.95,
              "estimated_amount": 12.95
            },
            {
              "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": 33.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.08,
              "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": 31.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.74
            },
            {
              "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": 21.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 12.95,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.08,
              "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": 27.74
            },
            {
              "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": 32.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.56,
              "estimated_amount": 48.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.4
            },
            {
              "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": 24.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 24.02
            },
            {
              "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": 27.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.5
            }
          ],
          "minimum": 12.95,
          "maximum": 48.56
        }
      ]
    },
    {
      "description": "Barrier Strip Elastic Y-Shaped",
      "code_information": [
        {
          "code": "PX-CH-CO120701",
          "type": "CDM"
        },
        {
          "code": "A4362",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.04,
          "discounted_cash": 1.98,
          "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": 1.95
            },
            {
              "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
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 2.58
            },
            {
              "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": "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": "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": "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 2.49
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 1.67
            },
            {
              "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 1.67
            },
            {
              "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": 3.04,
              "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": 1.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "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": 1.67
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.22
            },
            {
              "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": 2.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.52
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 63.2,
              "estimated_amount": 1.92
            },
            {
              "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": "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": "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 2.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "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": 2.22
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "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": 1.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "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": 1.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "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": "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": 3.04,
              "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": 1.95
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 3.04,
              "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": 3.04,
              "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": 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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 1.92
            },
            {
              "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": "AETNA [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": "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": "AETNA [310]",
              "plan_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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "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": 3.04,
              "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": "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": "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": 3.04,
              "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": 1.92
            },
            {
              "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": 1.92
            },
            {
              "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": "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 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": 1.98
            },
            {
              "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 3.04,
              "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": 3.04,
              "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": 1.69
            },
            {
              "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": 3.04,
              "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": 3.04,
              "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": 2.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.04,
              "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": 1.95
            },
            {
              "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": 3.04,
              "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": 3.04,
              "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": 2.52
            },
            {
              "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": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            }
          ]
        }
      ]
    },
    {
      "description": "HC Alkaline Phosphatase So",
      "code_information": [
        {
          "code": "PX-30101247",
          "type": "CDM"
        },
        {
          "code": "84075",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10,
          "discounted_cash": 6.5,
          "minimum": 4.26,
          "maximum": 19.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 7.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": 8.8
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": 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": 8.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "estimated_amount": 4.26
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "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": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 10,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": 6.5
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.5
            },
            {
              "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": "UHC 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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "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": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.56,
              "estimated_amount": 7.56
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "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": 10
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "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": "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": "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": "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": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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 UMR CHOICE PLUS [625250]",
              "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": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.56,
              "estimated_amount": 7.56
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": 4.5
            },
            {
              "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": 5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.56,
              "estimated_amount": 7.56
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 8.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "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": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "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": "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 MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": 2.5
            },
            {
              "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": 8.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": "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": "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": "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ph Body Fluid Nos So",
      "code_information": [
        {
          "code": "PX-30101256",
          "type": "CDM"
        },
        {
          "code": "83986",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34,
          "discounted_cash": 22.1,
          "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": 21.83
            },
            {
              "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": 21.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "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": 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": 29.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.19
            },
            {
              "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": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.23,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.62,
              "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": 29.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "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": 27.88
            },
            {
              "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": 29.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.58,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.62,
              "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": 25.5
            },
            {
              "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": 22.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.82
            },
            {
              "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": 21.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "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": 9.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "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": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.58,
              "estimated_amount": 3.58
            },
            {
              "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": 21.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.82
            },
            {
              "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": 21.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.58,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.76,
              "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": 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": 27.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.62,
              "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": 18.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.62,
              "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": 28.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.19
            },
            {
              "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": 28.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "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": 18.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.58,
              "estimated_amount": 3.58
            },
            {
              "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": 21.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.13
            },
            {
              "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": 27.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "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": 22.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.58,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.82
            },
            {
              "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": 28.19
            },
            {
              "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": 27.88
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.58,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.23,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "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": 21.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "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": 34,
              "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": 34,
              "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": 27.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "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": 27.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.43,
              "estimated_amount": 13.43
            },
            {
              "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": 22.1
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.23,
              "estimated_amount": 5.23
            },
            {
              "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": 18.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.5
            },
            {
              "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": 34,
              "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": 21.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 3.58,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 3.76,
              "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": 28.9
            },
            {
              "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": 24.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.58,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            }
          ],
          "minimum": 3.58,
          "maximum": 13.43
        }
      ]
    },
    {
      "description": "HC Ammonia So",
      "code_information": [
        {
          "code": "PX-30101257",
          "type": "CDM"
        },
        {
          "code": "82140",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 350,
          "discounted_cash": 227.5,
          "minimum": 12.51,
          "maximum": 54.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 308
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "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": 287
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.3,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "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": 175
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 227.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 157.5
            },
            {
              "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": 157.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.3,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 262.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 350,
              "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": 350,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 157.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "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": 350,
              "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": 45,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.3,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 287
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 255.5
            },
            {
              "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": 255.5
            },
            {
              "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": 157.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 262.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 297.5
            },
            {
              "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": 297.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "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": 175
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 350
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 192.5
            },
            {
              "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": 287
            },
            {
              "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": 87.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 175
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 262.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.75,
              "estimated_amount": 24.75
            },
            {
              "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": 287
            }
          ]
        }
      ]
    },
    {
      "description": "HC Encephalitis California Antibody So",
      "code_information": [
        {
          "code": "PX-30200088",
          "type": "CDM"
        },
        {
          "code": "86651",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 67,
          "discounted_cash": 43.55,
          "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": 43.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "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": 67,
              "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": 37.19
            },
            {
              "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": 43.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.01
            },
            {
              "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": 43.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "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": 58.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "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": 18.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.91
            },
            {
              "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": 56.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.19
            },
            {
              "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": 37.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.19,
              "estimated_amount": 13.19
            },
            {
              "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": 42.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.77,
              "estimated_amount": 18.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 50.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.19,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.19,
              "estimated_amount": 13.19
            },
            {
              "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": 67,
              "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": 43.01
            },
            {
              "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": 54.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.32,
              "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": 36.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "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": 36.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.19,
              "estimated_amount": 13.19
            },
            {
              "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": 54.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "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": 56.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.32,
              "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": 54.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.32,
              "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": 67,
              "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": 55.54
            },
            {
              "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": 54.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.19,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.94
            },
            {
              "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": 48.91
            },
            {
              "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": 54.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.34
            },
            {
              "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": 58.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.32,
              "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": 55.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.77,
              "estimated_amount": 18.77
            },
            {
              "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": 43.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.19,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.85
            },
            {
              "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": 58.96
            },
            {
              "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": 43.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.77,
              "estimated_amount": 18.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "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": 43.55
            },
            {
              "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": 42.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.01
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "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": 42.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.85,
              "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": 13.19,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.19,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.32,
              "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": 42.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.25
            },
            {
              "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": 43.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.46,
              "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": 56.95
            },
            {
              "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": 37.19
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.01
            },
            {
              "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": 43.62
            }
          ],
          "minimum": 13.19,
          "maximum": 49.46
        }
      ]
    },
    {
      "description": "Ehrlichia Antibody Sendout",
      "code_information": [
        {
          "code": "PX-30200096",
          "type": "CDM"
        },
        {
          "code": "86666",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 116,
          "discounted_cash": 75.4,
          "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": 74.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.18,
              "estimated_amount": 10.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 96.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "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": 96.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.18,
              "estimated_amount": 10.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "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": 31.67
            },
            {
              "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": 75.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.28,
              "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": 73.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.12
            },
            {
              "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": 74.47
            },
            {
              "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": 74.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.52
            },
            {
              "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": 93.84
            },
            {
              "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": 98.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 93.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.49,
              "estimated_amount": 14.49
            },
            {
              "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": 101.73
            },
            {
              "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": 73.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.8
            },
            {
              "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": 63.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.12
            },
            {
              "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": 73.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.18,
              "estimated_amount": 10.18
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.49,
              "estimated_amount": 14.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "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": 64.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.47
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.18,
              "estimated_amount": 10.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.18,
              "estimated_amount": 10.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "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": 84.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.28,
              "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": 73.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 116
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.18,
              "estimated_amount": 10.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 64.38
            },
            {
              "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": 98.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "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": 75.52
            },
            {
              "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": 95.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.28,
              "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": 101.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "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": 95.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.49,
              "estimated_amount": 14.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.18,
              "estimated_amount": 10.18
            },
            {
              "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": 73.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.47
            },
            {
              "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": 74.47
            },
            {
              "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": 74.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 96.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "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": 95.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "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": 102.08
            },
            {
              "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": 64.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "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": 63.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "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": 95.12
            },
            {
              "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": 64.38
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 10.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.18,
              "estimated_amount": 38.18
            },
            {
              "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": 74.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.52
            },
            {
              "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": 75.52
            }
          ],
          "minimum": 10.18,
          "maximum": 38.18
        }
      ]
    },
    {
      "description": "HC Histoplasma Antibody",
      "code_information": [
        {
          "code": "PX-30200109",
          "type": "CDM"
        },
        {
          "code": "86698",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 142,
          "discounted_cash": 92.3,
          "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": 91.16
            },
            {
              "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": 103.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "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": 124.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 106.5
            },
            {
              "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": 89.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.79,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.66
            },
            {
              "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": 120.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 142
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.79,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 106.5
            },
            {
              "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": 91.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.93,
              "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": 117.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 106.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.93,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.48,
              "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": 92.44
            },
            {
              "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": 92.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 92.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.79,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "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": 92.44
            },
            {
              "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": 116.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "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": 38.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.48,
              "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": 114.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.16
            },
            {
              "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": 116.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.44
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.79,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "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": 92.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.27,
              "estimated_amount": 18.27
            },
            {
              "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": 120.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 92.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.79,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.79,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.16
            },
            {
              "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": 116.44
            },
            {
              "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": 89.74
            },
            {
              "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": 124.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.16
            },
            {
              "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": 78.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.66
            },
            {
              "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": 142,
              "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": 120.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 78.81
            },
            {
              "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": 78.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "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": 91.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.93,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.79,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "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": 91.16
            },
            {
              "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": 78.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.16
            },
            {
              "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": 91.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.44
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.48,
              "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": 103.66
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.27,
              "estimated_amount": 18.27
            },
            {
              "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": 78.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.93,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.93,
              "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": 142,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "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": 142,
              "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": 120.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "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": 89.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.74
            },
            {
              "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": 124.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.71,
              "estimated_amount": 51.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 114.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.27,
              "estimated_amount": 18.27
            }
          ],
          "minimum": 13.79,
          "maximum": 51.71
        }
      ]
    },
    {
      "description": "Hepatitis Be Antibody Sendout",
      "code_information": [
        {
          "code": "PX-30200115",
          "type": "CDM"
        },
        {
          "code": "86707",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37,
          "discounted_cash": 24.05,
          "minimum": 9.92,
          "maximum": 43.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.34
            },
            {
              "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": 9.25
            },
            {
              "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": 37,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.9,
              "estimated_amount": 16.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 16.65
            },
            {
              "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": 30.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 50,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.92,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 37,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 16.65
            },
            {
              "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": 20.35
            },
            {
              "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": 30.34
            },
            {
              "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": 31.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 16.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 18.5
            },
            {
              "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": 18.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.9,
              "estimated_amount": 16.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 16.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 16.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.9,
              "estimated_amount": 16.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.92,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 32.56
            },
            {
              "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": 27.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 27.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 45,
              "estimated_amount": 16.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.92,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 16.65
            },
            {
              "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": 16.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "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": 18.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.01
            },
            {
              "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": 16.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 31.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 31.45
            },
            {
              "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": 30.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 16.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.35
            },
            {
              "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": 37,
              "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": 24.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.92,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.34
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.16,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tetanus Antibody",
      "code_information": [
        {
          "code": "PX-30200134",
          "type": "CDM"
        },
        {
          "code": "86774",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 145,
          "discounted_cash": 94.25,
          "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": 93.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "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": 105.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 94.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 80.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "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": 145,
              "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": 93.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.63,
              "estimated_amount": 21.63
            },
            {
              "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": 79.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 39.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 127.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "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": 94.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 120.21
            },
            {
              "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": 80.48
            },
            {
              "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": 94.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "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": 145,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "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": 93.09
            },
            {
              "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": 120.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.63,
              "estimated_amount": 21.63
            },
            {
              "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": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "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": 118.9
            },
            {
              "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": 123.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 120.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 127.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "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": 80.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "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": 118.9
            },
            {
              "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": 91.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "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": 145
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 145,
              "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": 91.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "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": 93.09
            },
            {
              "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": 80.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "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": 118.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 91.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "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": 127.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 117.31
            },
            {
              "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": 117.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            }
          ],
          "minimum": 21.63,
          "maximum": 55.5
        }
      ]
    },
    {
      "description": "Inner Cannula Disposable Fenestrated Size 4",
      "code_information": [
        {
          "code": "PX-CH-2M4DICFEN",
          "type": "CDM"
        },
        {
          "code": "A4623",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.37,
          "discounted_cash": 4.14,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 6.37,
              "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": 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": 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": 5.15
            },
            {
              "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": 5.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.03
            },
            {
              "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": 5.59
            },
            {
              "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": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 6.37,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.5
            },
            {
              "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": 6.37,
              "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": 5.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.15
            },
            {
              "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": 4.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 4.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 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": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 4.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 4.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            },
            {
              "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": 5.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 4.03
            },
            {
              "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": 6.37,
              "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": 6.37,
              "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": 5.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 4.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.65
            },
            {
              "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": 4.03
            },
            {
              "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": 6.37,
              "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": 6.37,
              "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": 4.78
            },
            {
              "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": 4.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 5.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.74
            },
            {
              "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": 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": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "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": 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": 4.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.37,
              "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": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            },
            {
              "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": 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": 5.22
            },
            {
              "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": 6.37,
              "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": 4.65
            },
            {
              "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": 4.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 3.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.15
            },
            {
              "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": 3.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.37,
              "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": 3.5
            },
            {
              "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": 5.22
            },
            {
              "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": 5.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            }
          ]
        }
      ]
    },
    {
      "description": "HC Crossmatch Platelet",
      "code_information": [
        {
          "code": "PX-30200146",
          "type": "CDM"
        },
        {
          "code": "86806",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1837,
          "discounted_cash": 1194.05,
          "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": 1179.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1160.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "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": 1837,
              "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": 1561.45
            },
            {
              "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": 1194.05
            },
            {
              "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": 1837,
              "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": 1160.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "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": 1837,
              "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": 1195.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1019.54
            },
            {
              "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": 1195.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1506.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1160.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "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": 1341.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1341.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.74,
              "estimated_amount": 67.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1506.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1341.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1160.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.74,
              "estimated_amount": 67.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1010.35
            },
            {
              "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": 1010.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1341.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1179.35
            },
            {
              "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": 1486.13
            },
            {
              "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": 1506.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "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": 1019.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1179.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1486.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1195.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "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": 501.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "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": 1179.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "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": 1179.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1010.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1179.35
            },
            {
              "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": 1522.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1160.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "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": 1179.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1195.89
            },
            {
              "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": 1179.35
            },
            {
              "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": 1179.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1179.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "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": 1019.54
            },
            {
              "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": 1561.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1160.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1522.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1341.01
            },
            {
              "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": 1160.98
            },
            {
              "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": 1616.56
            },
            {
              "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": 1019.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1377.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1179.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1506.34
            },
            {
              "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": 1160.98
            },
            {
              "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": 1611.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1377.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1010.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1561.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1179.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1506.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1195.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1522.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1377.75
            },
            {
              "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": 1611.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1010.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1506.34
            },
            {
              "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": 1506.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1010.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 178.46,
              "estimated_amount": 178.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1837
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1010.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1341.01
            },
            {
              "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": 1506.34
            }
          ],
          "minimum": 67.74,
          "maximum": 178.46
        }
      ]
    },
    {
      "description": "2 Pc Pouch Uro 2 3/4 in Centerpointlock",
      "code_information": [
        {
          "code": "PX-CH-HO3904",
          "type": "CDM"
        },
        {
          "code": "A4432",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.38,
          "discounted_cash": 1.55,
          "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": 1.53
            },
            {
              "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": 0.65
            },
            {
              "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": "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": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.38,
              "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": 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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.38,
              "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": 1.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 1.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 1.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.02
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 1.32
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.02
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.38
            },
            {
              "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": 2.38,
              "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": 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": 1.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.38,
              "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": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.95
            },
            {
              "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": 1.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.38,
              "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": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.02
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 1.55
            },
            {
              "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": 1.31
            },
            {
              "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": 1.5
            },
            {
              "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": 2.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 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": 1.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.55
            },
            {
              "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": 1.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 2.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.5
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 1.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 1.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "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": 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": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.55
            },
            {
              "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": 2.38,
              "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": 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": 1.5
            },
            {
              "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": 2.38,
              "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": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "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": 1.97
            },
            {
              "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": 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": 2.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.38,
              "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": 2.38,
              "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": 2.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.95
            },
            {
              "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": 1.95
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe/Needle TB 1cc 27 G X 1/2 in Safety",
      "code_information": [
        {
          "code": "PX-CH-BD305553",
          "type": "CDM"
        },
        {
          "code": "A4206",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.7,
          "discounted_cash": 0.45,
          "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": 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": "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": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.61
            },
            {
              "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": "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": "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 MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.7,
              "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": 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": "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": "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": "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.7
            },
            {
              "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": 0.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "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": 0.45
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "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": "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": "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": "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": "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": "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": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "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": "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "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": "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "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": "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": "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": "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.7,
              "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": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "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": 0.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "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": "AETNA [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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "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": "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 PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.6
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.53
            },
            {
              "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": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.7,
              "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": 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": "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": "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": "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": "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": "BUCKEYE COMMUNITY 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": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.58
            },
            {
              "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": 0.57
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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 [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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "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": "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": "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": "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": "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": "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
            }
          ]
        }
      ]
    },
    {
      "description": "Afo Prefab Off the Shelf",
      "code_information": [
        {
          "code": "PX-27400279",
          "type": "CDM"
        },
        {
          "code": "L4397",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 64,
          "discounted_cash": 41.6,
          "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": 41.09
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 207.32,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "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": 41.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.09
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "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": 197.45,
              "estimated_amount": 197.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.06
            },
            {
              "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": 41.09
            },
            {
              "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": 41.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "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": 64,
              "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": 64,
              "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": 41.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "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": 35.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 197.45,
              "estimated_amount": 197.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 197.45,
              "estimated_amount": 197.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "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": 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": 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": 41.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.06
            },
            {
              "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": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 197.45,
              "estimated_amount": 197.45
            },
            {
              "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": 41.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 199.42,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 199.42,
              "additional_payer_notes": "DMEPOS 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": 35.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 199.42,
              "additional_payer_notes": "DMEPOS 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": 41.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 197.45,
              "estimated_amount": 197.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.09
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "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": 64,
              "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,
              "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": 197.45,
              "estimated_amount": 197.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 197.45,
              "estimated_amount": 197.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "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": 46.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 199.42,
              "additional_payer_notes": "DMEPOS 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,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 197.45,
              "estimated_amount": 197.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "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": 64,
              "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": 197.45,
              "estimated_amount": 197.45
            },
            {
              "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": 46.72
            },
            {
              "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": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 207.32,
              "additional_payer_notes": "DMEPOS 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": 35.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 207.32,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 46.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 197.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 199.42,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            }
          ],
          "minimum": 197.45,
          "maximum": 197.45
        }
      ]
    },
    {
      "description": "Gloves Nitrile Powder-Free Flexal Small Cardinal",
      "code_information": [
        {
          "code": "PX-CH-IMC5588TN02S",
          "type": "CDM"
        },
        {
          "code": "A4927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.04,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "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": 0.04,
              "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": 0.04,
              "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": 0.04,
              "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": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            },
            {
              "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": 0.04,
              "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": 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 CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 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": "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": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.03
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.03
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.04,
              "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": 0.04,
              "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": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.03
            },
            {
              "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": 0.03
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.03
            },
            {
              "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": 0.04,
              "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": 0.03
            },
            {
              "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 0.04,
              "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": 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": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.03
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.04,
              "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": 0.04,
              "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": 0.04,
              "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": 0.04,
              "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": 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": 0.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 0.04,
              "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": 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": 0.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.03
            },
            {
              "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": 0.03
            },
            {
              "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 OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 0.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.02
            },
            {
              "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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 0.03
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": "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": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.03
            },
            {
              "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": 0.04,
              "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": 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": "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": "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": "AETNA [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 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 GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.04,
              "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": 0.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Tape Silk Durapore 3 in X 10 Yds",
      "code_information": [
        {
          "code": "PX-CH-3M1538-3",
          "type": "CDM"
        },
        {
          "code": "A4452",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.01,
          "discounted_cash": 1.96,
          "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": 1.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.66
            },
            {
              "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": 3.01,
              "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": 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": 2.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.01,
              "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": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 3.01,
              "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": 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": 2.47
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "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": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 3.01,
              "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": 1.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 1.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 3.01,
              "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": 3.01,
              "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": 3.01,
              "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": 2.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 2.2
            },
            {
              "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": 1.67
            },
            {
              "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": 1.96
            },
            {
              "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": 3.01,
              "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": 1.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.2
            },
            {
              "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": 3.01,
              "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": 2.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 3.01,
              "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": 3.01,
              "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": 3.01,
              "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": 1.93
            },
            {
              "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": 2.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 2.56
            },
            {
              "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": 2.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.66
            },
            {
              "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": 1.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "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": 1.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 3.01,
              "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": 2.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.5
            },
            {
              "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": 2.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 1.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.44
            },
            {
              "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": 2.5
            },
            {
              "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": 1.9
            },
            {
              "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": 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": 2.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.66
            },
            {
              "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": 3.01,
              "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": 1.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "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": 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": 2.47
            },
            {
              "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": 2.64
            },
            {
              "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": 3.01,
              "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": 1.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.56
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.93
            },
            {
              "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": 2.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.01,
              "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": 3.01,
              "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": 2.26
            },
            {
              "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": 1.9
            },
            {
              "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": 1.96
            }
          ]
        }
      ]
    },
    {
      "description": "Shampoo/Body Wash/Peri-Foam 4 Oz Aloe Vesta 3 in 1",
      "code_information": [
        {
          "code": "PX-CH-CV3252-04",
          "type": "CDM"
        },
        {
          "code": "A4335",
          "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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "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": 9.47
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "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": 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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "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": 9.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "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": 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": "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": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "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": 11.55,
              "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": 6.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "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": 11.55,
              "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": 9.82
            },
            {
              "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": "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": "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 OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 7.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.55,
              "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": 9.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "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": "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": 11.55,
              "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": 11.55,
              "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": 9.82
            },
            {
              "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "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": 9.57
            },
            {
              "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": 7.52
            },
            {
              "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "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": 11.55,
              "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": 7.52
            },
            {
              "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": 7.42
            },
            {
              "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": "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 ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.13
            },
            {
              "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": "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 HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 9.82
            },
            {
              "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": 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": 8.43
            },
            {
              "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": 11.55,
              "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": 11.55,
              "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": 7.3
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "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": 11.55,
              "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": 11.55,
              "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": 10.16
            },
            {
              "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": 11.55,
              "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": 6.35
            },
            {
              "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": 9.82
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "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": 11.55,
              "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": 7.42
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 8.43
            },
            {
              "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": 10.13
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.55,
              "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": 7.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 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": 7.52
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "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": 11.55,
              "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": 7.3
            },
            {
              "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": "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 OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.43
            },
            {
              "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": 11.55,
              "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": 6.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.55,
              "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": 11.55,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Underpad 30 in X 30 in Max Absorb Preferred",
      "code_information": [
        {
          "code": "PX-CH-55MAX3030UPS",
          "type": "CDM"
        },
        {
          "code": "A4554",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.43,
          "discounted_cash": 0.28,
          "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": 0.28
            },
            {
              "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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "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": 0.35
            },
            {
              "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": "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": "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 MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.43,
              "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": 0.27
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.43,
              "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": 0.37
            },
            {
              "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": 0.28
            },
            {
              "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": 0.28
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "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": 0.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "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": "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": "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": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "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": 0.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "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": 0.28
            },
            {
              "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": "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": "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": "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": "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 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": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.43,
              "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": 0.27
            },
            {
              "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": "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": "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.43,
              "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": 0.28
            },
            {
              "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": "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": "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": "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": "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": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "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": "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.37
            },
            {
              "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": 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": 0.32
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "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": "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": "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": "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "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": 0.28
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.38
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.43,
              "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": 0.24
            },
            {
              "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": 0.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "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": 0.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.36
            },
            {
              "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": 0.37
            },
            {
              "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": 0.38
            },
            {
              "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": "Hydrocolloid Drsg Duoderm Cgf Border 6 in X 6 In",
      "code_information": [
        {
          "code": "PX-CH-CV1879-72",
          "type": "CDM"
        },
        {
          "code": "A6238",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 54.03,
          "discounted_cash": 35.12,
          "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": 34.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 54.03,
              "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": 34.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.93
            },
            {
              "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": 44.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 43.71
            },
            {
              "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": 54.03,
              "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": 54.03,
              "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": 54.03,
              "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": 54.03,
              "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": 54.03,
              "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": 29.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.44
            },
            {
              "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": 47.55
            },
            {
              "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": 29.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.44
            },
            {
              "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": 54.03,
              "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": 54.03,
              "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": 54.03,
              "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": 35.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.3
            },
            {
              "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": 35.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 29.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.52
            },
            {
              "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": 54.03,
              "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": 54.03,
              "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": 34.69
            },
            {
              "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": 34.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 54.03,
              "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": 45.93
            },
            {
              "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": 34.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.71
            },
            {
              "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": 29.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.44
            },
            {
              "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": 54.03,
              "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": 45.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.69
            },
            {
              "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": 44.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.3
            },
            {
              "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": 54.03,
              "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": 44.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.79
            },
            {
              "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": 47.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 54.03,
              "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": 29.72
            },
            {
              "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": 34.15
            },
            {
              "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": 54.03,
              "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": 34.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 54.03,
              "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": 54.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 45.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.93
            },
            {
              "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": 14.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 44.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.3
            },
            {
              "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": 54.03,
              "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": 54.03,
              "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": 34.69
            },
            {
              "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": 34.69
            },
            {
              "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": 34.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 54.03,
              "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": 54.03,
              "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": 54.03,
              "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": 45.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.69
            },
            {
              "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": 34.69
            },
            {
              "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": 54.03,
              "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": 45.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.03,
              "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": 35.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 54.03,
              "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": 35.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.93
            },
            {
              "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": 47.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.03,
              "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": 54.03,
              "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": 29.99
            },
            {
              "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": 39.44
            },
            {
              "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": 45.93
            },
            {
              "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": 54.03,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Border Allevyn Life 6 in X 6 In",
      "code_information": [
        {
          "code": "PX-CH-UN66801069",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14.04,
          "discounted_cash": 9.13,
          "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": 9.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 11.51
            },
            {
              "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": 12.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 10.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.01
            },
            {
              "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": 14.04,
              "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": 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": 8.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.72
            },
            {
              "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": 14.04,
              "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": 14.04
            },
            {
              "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": 14.04,
              "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": 14.04,
              "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": 7.79
            },
            {
              "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": 9.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 7.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 9.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 7.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.87
            },
            {
              "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": 9.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.51
            },
            {
              "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": 3.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.72
            },
            {
              "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": 11.93
            },
            {
              "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": 14.04,
              "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": 9.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 10.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 9.01
            },
            {
              "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": 11.51
            },
            {
              "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": 11.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 14.04,
              "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": 11.93
            },
            {
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 9.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 10.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.25
            },
            {
              "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": 11.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.51
            },
            {
              "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": 10.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "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": 12.31
            },
            {
              "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": 14.04,
              "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": 9.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.87
            },
            {
              "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": 14.04,
              "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": 10.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.79
            },
            {
              "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": 14.04,
              "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": 14.04,
              "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": 11.36
            },
            {
              "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": 7.79
            },
            {
              "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": 12.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.72
            },
            {
              "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": 7.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.51
            },
            {
              "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": 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": 8.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.72
            },
            {
              "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": 14.04,
              "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": 14.04,
              "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": 14.04,
              "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": 63.2,
              "estimated_amount": 8.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 9.14
            },
            {
              "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": 14.04,
              "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": 8.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.51
            },
            {
              "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": 14.04,
              "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": 8.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.04,
              "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": 11.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.72
            }
          ]
        }
      ]
    },
    {
      "description": "HC Factor 8 Clotting Assay",
      "code_information": [
        {
          "code": "PX-30500021",
          "type": "CDM"
        },
        {
          "code": "85240",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1345,
          "discounted_cash": 874.25,
          "minimum": 6.66,
          "maximum": 67.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": 672.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 739.75
            },
            {
              "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": 605.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.36,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": 1345,
              "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": 1183.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 605.25
            },
            {
              "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": 605.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "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": 1345,
              "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": 981.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 981.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 605.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 739.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "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": 1102.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1102.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1345
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "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": 874.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 605.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1008.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1102.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1102.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "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": 981.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.36,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.66,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 981.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "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": 1143.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 605.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 672.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1102.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "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": 1143.25
            },
            {
              "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": 1345,
              "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": 1143.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "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": 336.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 739.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 605.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.36,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 605.25
            },
            {
              "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": 605.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 605.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "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": 1102.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1008.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1008.75
            },
            {
              "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": 1102.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 739.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": 739.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 739.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 981.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": 1143.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 739.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1143.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 672.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1102.9
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.36,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.66,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 294.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 981.85
            }
          ]
        }
      ]
    },
    {
      "description": "Factor 8 Vonwillebrand Antigen Sendout",
      "code_information": [
        {
          "code": "PX-30500024",
          "type": "CDM"
        },
        {
          "code": "85246",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 86,
          "discounted_cash": 55.9,
          "minimum": 18.16,
          "maximum": 86.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "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": 70.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "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": 38.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "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": 73.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "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": 75.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "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": 86,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 55.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "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": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "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": 38.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "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": 73.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.52
            },
            {
              "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": 70.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 47.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 70.52
            },
            {
              "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": 62.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 70.52
            },
            {
              "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": 21.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "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": 73.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 22.94,
              "estimated_amount": 22.94
            },
            {
              "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": 38.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.1
            },
            {
              "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": 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": 70.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "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": 86,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 38.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.78
            },
            {
              "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": 86,
              "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": 73.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 43
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 3034,
          "discounted_cash": 1972.1,
          "payers_information": [
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "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": 664.45
            },
            {
              "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": 2578.9
            },
            {
              "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": 758.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1668.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1668.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "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": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2214.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 2578.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2275.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "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": 3034,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2214.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1668.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2214.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3034
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.54,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 1517
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2275.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 2578.9
            },
            {
              "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": 1972.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1668.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1668.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.68,
              "estimated_amount": 19.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1668.7
            },
            {
              "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": 2214.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2487.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2214.82
            },
            {
              "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": 3034,
              "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": 50,
              "estimated_amount": 1517
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "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": 1668.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "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": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "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": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 86.03,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2275.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2578.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2214.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 23.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 22.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.09,
              "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": 3034,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.94,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.16,
              "estimated_amount": 18.16
            },
            {
              "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": 2669.92
            }
          ],
          "minimum": 18.16,
          "maximum": 86.03
        }
      ]
    },
    {
      "description": "HC Heparin Assay",
      "code_information": [
        {
          "code": "PX-30500057",
          "type": "CDM"
        },
        {
          "code": "85520",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1661,
          "discounted_cash": 1079.65,
          "minimum": 11.22,
          "maximum": 49.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.22,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.22,
              "estimated_amount": 11.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1245.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 913.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1212.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.39,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "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": 1212.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "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": 1411.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.74,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.22,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.13,
              "estimated_amount": 19.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 913.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1212.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.22,
              "estimated_amount": 11.22
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.13,
              "estimated_amount": 19.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.22,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "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": 1362.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1212.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "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": 913.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.39,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.22,
              "estimated_amount": 11.22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.74,
              "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": 13.09,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1212.53
            },
            {
              "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": 1362.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.22,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "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": 415.25
            },
            {
              "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": 913.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "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": 1079.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1362.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "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": 363.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "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": 1411.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "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": 1461.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 913.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1362.02
            },
            {
              "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": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1661
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1212.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 913.55
            },
            {
              "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": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1362.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.99,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.74,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "estimated_amount": 13.09
            },
            {
              "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": 1362.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1661,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1362.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1245.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 913.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.22,
              "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": 1411.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1245.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1411.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.09,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.09,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.22,
              "estimated_amount": 11.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1362.02
            }
          ]
        }
      ]
    },
    {
      "description": "HC Concentration Afb",
      "code_information": [
        {
          "code": "PX-30600007",
          "type": "CDM"
        },
        {
          "code": "87015",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 129,
          "discounted_cash": 83.85,
          "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": 82.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 105.78
            },
            {
              "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": 83.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.43,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.43,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.01,
              "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": 106.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "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": 105.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 105.78
            },
            {
              "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": 113.52
            },
            {
              "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": 82.82
            },
            {
              "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": 105.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.68,
              "estimated_amount": 6.68
            },
            {
              "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": 71.6
            },
            {
              "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": 113.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.75,
              "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": 94.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.68,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.68,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "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": 82.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 83.98
            },
            {
              "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": 104.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 83.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 96.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.17
            },
            {
              "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": 71.6
            },
            {
              "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": 82.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 104.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.95
            },
            {
              "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": 81.53
            },
            {
              "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": 82.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "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": 81.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "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": 129,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.01,
              "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": 109.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 106.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.43,
              "estimated_amount": 8.43
            },
            {
              "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": 70.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "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": 109.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 105.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 83.98
            },
            {
              "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": 81.53
            },
            {
              "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": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.75,
              "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": 81.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 129
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 96.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.68,
              "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": 94.17
            },
            {
              "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 [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 105.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 96.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.75,
              "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": 70.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.75,
              "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": 71.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.17
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.68,
              "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": 35.22
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.68,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 70.95
            },
            {
              "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": 94.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 106.94
            },
            {
              "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": 82.82
            },
            {
              "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": 83.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "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": 129,
              "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": 105.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.68,
              "estimated_amount": 6.68
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 71.6
            },
            {
              "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": 129,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "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": 105.78
            },
            {
              "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": 109.65
            },
            {
              "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": 113.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            },
            {
              "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/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 6.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 83.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.65
            }
          ],
          "minimum": 6.68,
          "maximum": 25.05
        }
      ]
    },
    {
      "description": "HC Bacterial Identification",
      "code_information": [
        {
          "code": "PX-30600058",
          "type": "CDM"
        },
        {
          "code": "87077",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 186,
          "discounted_cash": 120.9,
          "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": 64.2,
              "estimated_amount": 119.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 139.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "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": 186,
              "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": 119.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.41
            },
            {
              "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": 121.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.78
            },
            {
              "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": 119.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "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": 117.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.41
            },
            {
              "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": 152.52
            },
            {
              "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": 119.41
            },
            {
              "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": 152.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.08,
              "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": 158.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.8,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "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": 102.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.16,
              "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": 119.41
            },
            {
              "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": 120.9
            },
            {
              "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": 103.23
            },
            {
              "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": 103.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.16,
              "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": 8.08,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.52
            },
            {
              "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": 50.78
            },
            {
              "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": 163.68
            },
            {
              "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": 117.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 117.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "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": 154.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 139.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "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": 186,
              "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": 186,
              "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": 121.09
            },
            {
              "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": 121.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.55
            },
            {
              "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": 163.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.08,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.48,
              "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": 163.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "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": 150.47
            },
            {
              "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": 119.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "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": 119.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 150.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 103.23
            },
            {
              "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": 158.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.41
            },
            {
              "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": 152.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 154.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.3
            },
            {
              "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": 158.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 186
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.16,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.08,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 154.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.08,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.16,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.8,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.08,
              "estimated_amount": 8.08
            },
            {
              "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": 103.23
            },
            {
              "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": 135.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 8.08,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.16,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.8,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.3,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.08,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 139.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.78
            }
          ],
          "minimum": 8.08,
          "maximum": 30.3
        }
      ]
    },
    {
      "description": "HC Culture Presumptive Path Org Scrn",
      "code_information": [
        {
          "code": "PX-30600066",
          "type": "CDM"
        },
        {
          "code": "87081",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 156,
          "discounted_cash": 101.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "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": 100.15
            },
            {
              "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": 85.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.69,
              "estimated_amount": 9.69
            },
            {
              "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": 98.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.63,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "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": 136.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "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": 101.4
            },
            {
              "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": 100.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "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": 132.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.63,
              "estimated_amount": 6.63
            },
            {
              "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": 98.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "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": 127.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "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": 132.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "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": 100.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.96,
              "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": 132.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.68,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "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": 101.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.96,
              "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": 156,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "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": 156
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.68,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "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": 127.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 126.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.63,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "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": 137.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.69,
              "estimated_amount": 9.69
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.69,
              "estimated_amount": 9.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.68,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 156,
              "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": 127.92
            },
            {
              "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": 127.92
            },
            {
              "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": 136.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.63,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.68,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "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": 100.15
            },
            {
              "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": 100.15
            },
            {
              "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": 113.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "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": 156,
              "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": 117
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 126.2
            },
            {
              "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": 42.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "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": 98.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.63,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 98.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.63,
              "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": 98.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 6.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.96,
              "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": 85.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.86,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "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": 101.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.63,
              "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": 85.8
            }
          ],
          "minimum": 5.68,
          "maximum": 24.86
        }
      ]
    },
    {
      "description": "HC Culture Viral Cmv",
      "code_information": [
        {
          "code": "PX-30600169",
          "type": "CDM"
        },
        {
          "code": "87253",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 209,
          "discounted_cash": 135.85,
          "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": 134.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "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": 114.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.18
            },
            {
              "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": 152.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.95
            },
            {
              "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": 134.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 171.38
            },
            {
              "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": 171.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.09
            },
            {
              "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": 209,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.51,
              "estimated_amount": 29.51
            },
            {
              "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": 134.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 171.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "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": 132.09
            },
            {
              "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": 134.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 171.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "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": 209,
              "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": 114.95
            },
            {
              "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": 183.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 171.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 169.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.57
            },
            {
              "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": 132.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.09
            },
            {
              "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": 183.29
            },
            {
              "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": 116
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.18
            },
            {
              "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": 136.06
            },
            {
              "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": 57.06
            },
            {
              "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": 116
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.18
            },
            {
              "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": 171.38
            },
            {
              "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": 132.09
            },
            {
              "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": 209,
              "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": 132.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.57
            },
            {
              "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": 116
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "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": 183.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "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": 173.26
            },
            {
              "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": 177.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156.75
            },
            {
              "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": 134.18
            },
            {
              "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": 136.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.51,
              "estimated_amount": 29.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "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": 135.85
            },
            {
              "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": 177.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 173.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "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": 171.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 173.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.95
            },
            {
              "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": 169.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 209
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 171.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156.75
            },
            {
              "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": 134.18
            }
          ],
          "minimum": 29.51,
          "maximum": 75.75
        }
      ]
    },
    {
      "description": "HC Influenza Dna Amp Probe Addl",
      "code_information": [
        {
          "code": "PX-30600206",
          "type": "CDM"
        },
        {
          "code": "87503",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 99,
          "discounted_cash": 64.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 64.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": 84.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 64.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 82.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": 27.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "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": 86.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "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": "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": 84.15
            },
            {
              "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": 64.45
            },
            {
              "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": 81.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "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": 63.56
            },
            {
              "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": 63.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": 82.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "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": 63.56
            },
            {
              "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": 54.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "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": 64.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 80.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "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": 99,
              "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": 62.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 82.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 64.45
            },
            {
              "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": 63.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "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": "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]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "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": 72.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.56,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": 62.57
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.56,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "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": 54.95
            },
            {
              "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": 86.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "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": 81.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "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": 54.45
            },
            {
              "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": 99,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "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": 63.56
            },
            {
              "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": 64.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 109.58,
              "estimated_amount": 109.58
            },
            {
              "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": 87.12
            },
            {
              "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": 54.95
            },
            {
              "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": 80.09
            },
            {
              "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": 99,
              "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": 62.57
            }
          ],
          "minimum": 29.56,
          "maximum": 109.58
        }
      ]
    },
    {
      "description": "HC Dna Probe Amplified Pcr",
      "code_information": [
        {
          "code": "PX-30600243",
          "type": "CDM"
        },
        {
          "code": "87798",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 790,
          "discounted_cash": 513.5,
          "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": 507.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 647.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 647.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 507.18
            },
            {
              "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": 647.8
            },
            {
              "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": 514.29
            },
            {
              "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": 438.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 499.28
            },
            {
              "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": 692.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 692.83
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 507.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 514.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 671.5
            },
            {
              "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": 438.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 790,
              "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": 507.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 507.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 499.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 592.5
            },
            {
              "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": 434.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "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": 576.7
            },
            {
              "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": 671.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "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": 215.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 671.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 434.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "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": 507.18
            },
            {
              "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": 639.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 654.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 434.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 576.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 647.8
            },
            {
              "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": 499.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 499.28
            },
            {
              "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": 790,
              "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": 434.5
            },
            {
              "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": 576.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 507.18
            },
            {
              "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": 514.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 647.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 434.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 434.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 576.7
            },
            {
              "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": 507.18
            },
            {
              "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": 647.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 514.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 513.5
            },
            {
              "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": 507.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 790,
              "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": 790
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 507.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 592.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 592.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 499.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 647.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 639.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 499.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "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": 654.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 499.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 514.29
            },
            {
              "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": 438.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 576.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "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": 695.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 438.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 654.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 647.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 576.7
            },
            {
              "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": 499.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 434.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 671.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "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": 671.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 671.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 507.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 507.18
            }
          ],
          "minimum": 35.09,
          "maximum": 131.59
        }
      ]
    },
    {
      "description": "HC Inf Agnt Drg Sscep Phen Pred Bioi So",
      "code_information": [
        {
          "code": "PX-30600268",
          "type": "CDM"
        },
        {
          "code": "87900",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 759,
          "discounted_cash": 493.35,
          "minimum": 111.81,
          "maximum": 488.81,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 417.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 645.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111.81,
              "estimated_amount": 111.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111.81,
              "estimated_amount": 111.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 192.55,
              "estimated_amount": 192.55
            },
            {
              "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": 417.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 131.65,
              "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": 417.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 554.07
            },
            {
              "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": 645.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 136.87,
              "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": 645.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 136.87,
              "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": 554.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 645.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 153.39,
              "estimated_amount": 153.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 131.65,
              "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": 645.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 622.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 569.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 569.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 759
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 192.55,
              "estimated_amount": 192.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 153.39,
              "estimated_amount": 153.39
            },
            {
              "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": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 667.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 622.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 645.15
            },
            {
              "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": 554.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 131.65,
              "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": 25,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 417.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111.81,
              "estimated_amount": 111.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "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": 645.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 622.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 645.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 645.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 417.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "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": 493.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 131.65,
              "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": 130.35,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111.81,
              "estimated_amount": 111.81
            },
            {
              "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": 622.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 645.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 192.55,
              "estimated_amount": 192.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "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": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 136.87,
              "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": 645.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 417.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 130.35,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 131.65,
              "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": 645.15
            },
            {
              "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": 622.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 622.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 488.81,
              "estimated_amount": 488.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "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": 622.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 130.35,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.1,
              "estimated_amount": 169.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 759,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 417.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 194.73,
              "estimated_amount": 194.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 569.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 622.38
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cytopath Fluid Smear",
      "code_information": [
        {
          "code": "PX-31000001",
          "type": "CDM"
        },
        {
          "code": "88104",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 292,
          "discounted_cash": 189.8,
          "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": 187.46
            },
            {
              "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": 239.44
            },
            {
              "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": 292,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 187.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "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": 184.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "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": 239.44
            },
            {
              "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": 36.75,
              "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": 248.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 184.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "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": 160.6
            },
            {
              "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": 35.35,
              "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": 256.08
            },
            {
              "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": 35.35,
              "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": 162.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 213.16
            },
            {
              "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": 36.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 239.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "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": 162.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 219
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "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": 187.46
            },
            {
              "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": 187.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 190.09
            },
            {
              "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": 34.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 187.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 190.09
            },
            {
              "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": 236.23
            },
            {
              "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": 35.35,
              "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": 35.35,
              "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": 187.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 236.23
            },
            {
              "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": 239.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 242.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "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": 34.96,
              "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": 248.2
            },
            {
              "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": 292,
              "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": 190.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 239.44
            },
            {
              "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": 256.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 213.16
            },
            {
              "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": 213.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 187.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.6
            },
            {
              "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": 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": 292,
              "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": 187.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 239.44
            },
            {
              "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": 79.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 213.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "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": 36.75,
              "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": 184.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "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": 162.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.18,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 184.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 184.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 190.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.6
            },
            {
              "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": 35.35,
              "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": 248.2
            },
            {
              "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": 35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 239.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 219
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 256.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 127.35,
              "estimated_amount": 127.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "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": 189.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 213.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 162.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 242.07
            },
            {
              "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": 184.54
            },
            {
              "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": 248.2
            },
            {
              "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": 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": 160.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 213.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 248.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.18,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 184.54
            },
            {
              "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": 190.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 239.44
            },
            {
              "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": 187.46
            },
            {
              "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": 184.54
            },
            {
              "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": 34.96,
              "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": 160.6
            },
            {
              "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": 35,
              "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": 242.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.18,
              "estimated_amount": 20.18
            },
            {
              "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": 187.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 187.46
            },
            {
              "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": 187.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 219
            }
          ],
          "minimum": 20.18,
          "maximum": 127.35
        }
      ]
    },
    {
      "description": "Cyp Fish Urinary Morh Each Manual Sendout",
      "code_information": [
        {
          "code": "PX-31000005",
          "type": "CDM"
        },
        {
          "code": "88120",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 794,
          "discounted_cash": 516.1,
          "payers_information": [
            {
              "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": 496.25
            },
            {
              "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": 149.07,
              "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": 579.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "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": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 496.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.39,
              "estimated_amount": 466.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 149.07,
              "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": 794
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 149.07,
              "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": 62.5,
              "estimated_amount": 496.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 409.2,
              "estimated_amount": 409.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 496.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 409.2,
              "estimated_amount": 409.2
            },
            {
              "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": 150.57,
              "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": 674.9
            },
            {
              "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": 651.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "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": 674.9
            },
            {
              "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": 159.47,
              "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": 651.08
            },
            {
              "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": 156.53,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "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": 516.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 156.53,
              "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": 651.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.5
            },
            {
              "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": 496.25
            },
            {
              "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": 496.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 149.07,
              "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": 436.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "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": 150.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 496.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.12,
              "estimated_amount": 208.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "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": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 698.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 496.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "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": 150.57,
              "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": 149.07,
              "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": 651.08
            },
            {
              "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": 198.5
            },
            {
              "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": 149.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.12,
              "estimated_amount": 208.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 159.47,
              "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": 674.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 496.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "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": 150.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 409.2,
              "estimated_amount": 409.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.39,
              "estimated_amount": 466.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.12,
              "estimated_amount": 208.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 159.47,
              "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": 150.57,
              "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": 436.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "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": 156.53,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 496.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 409.2,
              "estimated_amount": 409.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.5
            },
            {
              "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": 62.5,
              "estimated_amount": 496.25
            },
            {
              "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": 436.7
            },
            {
              "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": 579.62
            },
            {
              "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": 496.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 532.73,
              "estimated_amount": 532.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            }
          ],
          "minimum": 208.12,
          "maximum": 589.69
        }
      ]
    },
    {
      "description": "HC Immunofluorescent Study Ea Ab Dir",
      "code_information": [
        {
          "code": "PX-31000096",
          "type": "CDM"
        },
        {
          "code": "88346",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 309,
          "discounted_cash": 200.85,
          "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": 198.38
            },
            {
              "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": 84.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 201.16
            },
            {
              "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": 171.5
            },
            {
              "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": 171.5
            },
            {
              "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": 195.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 320.12,
              "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": 256.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.64,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 225.57
            },
            {
              "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": 198.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.64,
              "estimated_amount": 30.64
            },
            {
              "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": 198.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 200.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 309
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 171.5
            },
            {
              "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": 329.41,
              "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": 253.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 169.95
            },
            {
              "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": 169.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 225.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 329.41,
              "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": 253.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.64,
              "estimated_amount": 30.64
            },
            {
              "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": 262.65
            },
            {
              "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": 225.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 225.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 309,
              "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": 198.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 225.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 198.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 231.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 313.72,
              "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": 198.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 198.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 253.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 169.95
            },
            {
              "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": 256.16
            },
            {
              "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": 198.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "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": 313.72,
              "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": 313.72,
              "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": 262.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 198.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 225.57
            },
            {
              "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": 316.86,
              "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": 253.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 253.38
            },
            {
              "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": 309,
              "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": 195.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 198.38
            },
            {
              "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": 253.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 253.38
            },
            {
              "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": 316.86,
              "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": 201.16
            },
            {
              "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": 201.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 169.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 198.38
            },
            {
              "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": 249.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 253.38
            },
            {
              "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": 198.38
            },
            {
              "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": 201.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 169.95
            },
            {
              "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": 195.29
            },
            {
              "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": 320.12,
              "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": 262.65
            },
            {
              "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": 316.86,
              "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": 316.86,
              "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": 309,
              "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": 316.86,
              "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": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 256.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 169.95
            },
            {
              "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": 270.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 271.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 195.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 231.75
            },
            {
              "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": 262.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 320.12,
              "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": 249.98
            },
            {
              "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": 313.72,
              "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": 201.16
            },
            {
              "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": 329.41,
              "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": 270.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 171.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 169.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 231.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 262.65
            }
          ],
          "minimum": 30.64,
          "maximum": 1215.41
        }
      ]
    },
    {
      "description": "HC Morph Anyls Tumor Ihc Manual",
      "code_information": [
        {
          "code": "PX-31000102",
          "type": "CDM"
        },
        {
          "code": "88360",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1055,
          "discounted_cash": 685.75,
          "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": 677.31
            },
            {
              "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": 677.31
            },
            {
              "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": 853.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 874.6
            },
            {
              "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": 677.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 585.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 791.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "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": 150.57,
              "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": 770.15
            },
            {
              "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": 149.07,
              "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": 149.07,
              "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": 677.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 152.12,
              "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": 677.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 580.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 677.31
            },
            {
              "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": 865.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 580.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 874.6
            },
            {
              "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": 1055,
              "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": 150.57,
              "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": 686.81
            },
            {
              "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": 231.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 874.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "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": 685.75
            },
            {
              "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": 149.07,
              "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": 580.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 770.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 925.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 580.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "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": 156.53,
              "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": 585.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 791.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 580.25
            },
            {
              "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": 150.57,
              "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": 1055,
              "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": 928.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "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": 865.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 865.1
            },
            {
              "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": 156.53,
              "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": 896.75
            },
            {
              "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": 896.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 677.31
            },
            {
              "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": 585.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 791.25
            },
            {
              "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": 896.75
            },
            {
              "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": 1055,
              "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": 677.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 865.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 677.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 925.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 677.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 853.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 686.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 580.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.32,
              "estimated_amount": 67.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 770.15
            },
            {
              "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": 150.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.32,
              "estimated_amount": 67.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 156.53,
              "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": 666.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 686.81
            },
            {
              "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": 149.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 686.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 686.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 770.15
            },
            {
              "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": 770.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 666.76
            },
            {
              "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": 152.12,
              "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": 896.75
            },
            {
              "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": 865.1
            },
            {
              "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": 580.25
            },
            {
              "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": 150.57,
              "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": 677.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 865.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 865.1
            },
            {
              "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": 666.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 152.12,
              "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": 770.15
            },
            {
              "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": 585.53
            },
            {
              "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": 666.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 896.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1055
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 865.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 677.31
            },
            {
              "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": 288.02
            }
          ],
          "minimum": 67.32,
          "maximum": 589.69
        }
      ]
    },
    {
      "description": "HC in Situ Hybridization 1st Probe Stain",
      "code_information": [
        {
          "code": "PX-31000104",
          "type": "CDM"
        },
        {
          "code": "88365",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 302,
          "discounted_cash": 196.3,
          "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": 193.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.1
            },
            {
              "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": 190.86
            },
            {
              "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": 150.57,
              "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": 190.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 193.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 247.64
            },
            {
              "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": 150.57,
              "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": 220.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 193.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 193.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 152.12,
              "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": 256.7
            },
            {
              "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": 196.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 220.46
            },
            {
              "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": 256.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "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": 145.92,
              "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": 226.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 244.32
            },
            {
              "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": 145.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.24,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 220.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 193.88
            },
            {
              "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": 247.64
            },
            {
              "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": 247.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.1
            },
            {
              "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": 149.07,
              "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": 193.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 193.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.24,
              "estimated_amount": 40.24
            },
            {
              "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": 150.57,
              "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": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 196.6
            },
            {
              "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": 220.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.24,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 250.36
            },
            {
              "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": 167.61
            },
            {
              "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": 152.12,
              "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": 152.12,
              "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": 264.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 196.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "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": 167.61
            },
            {
              "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": 250.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 190.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.57,
              "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": 264.85
            },
            {
              "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": 302,
              "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": 156.53,
              "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": 149.07,
              "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": 63.2,
              "estimated_amount": 190.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 196.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 220.46
            },
            {
              "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": 150.57,
              "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": 302,
              "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": 247.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 193.88
            },
            {
              "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": 82.45
            },
            {
              "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": 265.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 167.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 156.53,
              "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": 167.61
            },
            {
              "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": 190.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 190.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 193.88
            },
            {
              "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": 247.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 247.64
            },
            {
              "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": 193.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 190.86
            },
            {
              "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": 244.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 226.5
            },
            {
              "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": 166.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 226.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 193.88
            },
            {
              "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": 193.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 247.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 190.86
            },
            {
              "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": 302,
              "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": 196.6
            },
            {
              "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": 256.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 302
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 196.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 247.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 250.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 256.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 220.46
            },
            {
              "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": 156.53,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 40.24,
          "maximum": 589.69
        }
      ]
    },
    {
      "description": "HC Fine Needle Aspiration Eval",
      "code_information": [
        {
          "code": "PX-31100006",
          "type": "CDM"
        },
        {
          "code": "88172",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 428,
          "discounted_cash": 278.2,
          "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": 274.78
            },
            {
              "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": 350.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "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": 428,
              "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": 278.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 270.5
            },
            {
              "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": 270.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 235.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 274.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 270.5
            },
            {
              "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": 375.36
            },
            {
              "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": 148.9,
              "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": 354.81
            },
            {
              "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": 346.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 350.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 148.9,
              "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": 428,
              "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": 237.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 312.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.88,
              "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": 270.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 354.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 278.63
            },
            {
              "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": 350.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 270.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 235.4
            },
            {
              "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": 149.07,
              "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": 156.53,
              "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": 363.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 278.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 274.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 350.96
            },
            {
              "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": 116.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 321
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 235.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 235.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 274.78
            },
            {
              "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": 149.07,
              "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": 274.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 274.78
            },
            {
              "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": 350.96
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 149.07,
              "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": 321
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.88,
              "estimated_amount": 15.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 274.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 274.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 235.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 312.44
            },
            {
              "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": 150.57,
              "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": 237.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 350.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "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": 270.5
            },
            {
              "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": 148.9,
              "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": 363.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 312.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 235.4
            },
            {
              "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": 149.07,
              "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": 428
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 237.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 350.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 270.5
            },
            {
              "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": 150.57,
              "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": 375.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 274.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 270.5
            },
            {
              "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": 428,
              "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": 312.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 354.81
            },
            {
              "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": 274.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 278.63
            },
            {
              "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": 278.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 312.44
            },
            {
              "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": 156.53,
              "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": 150.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "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": 376.64
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 312.44
            },
            {
              "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": 150.57,
              "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": 274.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 346.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 350.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.88,
              "estimated_amount": 15.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 235.4
            },
            {
              "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": 363.8
            },
            {
              "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": 156.53,
              "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": 274.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 363.8
            },
            {
              "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": 237.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 278.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 589.69,
              "estimated_amount": 589.69
            }
          ],
          "minimum": 15.88,
          "maximum": 589.69
        }
      ]
    },
    {
      "description": "HC Xr Sella Turcica",
      "code_information": [
        {
          "code": "PX-32000015",
          "type": "CDM"
        },
        {
          "code": "70240",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 272,
          "discounted_cash": 176.8,
          "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": 174.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "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": 198.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 272,
              "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": 171.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 272,
              "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": 149.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 177.07
            },
            {
              "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": 238.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 223.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 149.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 177.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 204
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 238.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 204
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "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": 272,
              "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": 231.2
            },
            {
              "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": 149.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "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": 177.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "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": 150.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 272,
              "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": 272,
              "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": 272,
              "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": 272,
              "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": 176.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "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": 171.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 272,
              "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": 231.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "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": 174.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "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": 150.96
            },
            {
              "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": 171.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "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": 177.07
            },
            {
              "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": 223.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 272
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.49
            },
            {
              "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": 231.2
            },
            {
              "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": 174.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "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": 223.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "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": 272,
              "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": 171.9
            },
            {
              "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": 150.96
            },
            {
              "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": 174.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 204
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 223.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 272,
              "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": 231.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 177.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "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": 174.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 220.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "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": 223.04
            },
            {
              "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": 272,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 231.2
            },
            {
              "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": 220.05
            },
            {
              "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": 231.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 272,
              "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": 272,
              "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": 74.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "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": 239.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "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": 174.62
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Tmj Open and Closed Mouth Unilat",
      "code_information": [
        {
          "code": "PX-32000018",
          "type": "CDM"
        },
        {
          "code": "70328",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 226,
          "discounted_cash": 146.9,
          "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": 145.09
            },
            {
              "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": 185.32
            },
            {
              "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": 185.32
            },
            {
              "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": 80.1,
              "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": 226,
              "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": 192.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 192.1
            },
            {
              "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": 198.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 226,
              "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": 226,
              "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": 145.09
            },
            {
              "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": 124.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.1,
              "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": 185.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 185.32
            },
            {
              "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": 80.1,
              "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": 192.1
            },
            {
              "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": 198.2
            },
            {
              "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": 142.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 147.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 124.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 192.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 142.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 192.1
            },
            {
              "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": 80.1,
              "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": 145.09
            },
            {
              "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": 83.28,
              "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": 192.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 124.3
            },
            {
              "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": 80.93,
              "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": 182.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 185.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 169.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 182.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 124.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 192.1
            },
            {
              "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": 226,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 80.1,
              "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": 226,
              "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": 145.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 185.32
            },
            {
              "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": 226,
              "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": 79.31,
              "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": 192.1
            },
            {
              "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": 145.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 124.3
            },
            {
              "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": 83.28,
              "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": 125.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 192.1
            },
            {
              "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": 142.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 80.93,
              "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": 226,
              "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": 192.1
            },
            {
              "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": 146.9
            },
            {
              "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": 79.31,
              "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": 79.31,
              "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": 226
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 125.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 187.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 142.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 226,
              "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": 145.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 187.35
            },
            {
              "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": 83.28,
              "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": 147.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 147.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 185.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 192.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 124.3
            },
            {
              "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": 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": 64.2,
              "estimated_amount": 145.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.09
            },
            {
              "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": 198.2
            },
            {
              "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": 142.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 80.93,
              "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": 164.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 192.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 169.5
            },
            {
              "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": 226,
              "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": 226,
              "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": 169.5
            },
            {
              "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": 147.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 226,
              "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": 226,
              "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": 145.09
            },
            {
              "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": 192.1
            },
            {
              "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": 226,
              "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": 142.83
            },
            {
              "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": 125.43
            },
            {
              "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": 147.13
            },
            {
              "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": 187.35
            },
            {
              "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": 192.1
            },
            {
              "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": 61.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.09
            },
            {
              "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": 125.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 226,
              "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": 142.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 124.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 185.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 142.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.98
            },
            {
              "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": 164.98
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Cervical Spine 4 to 5 Vw",
      "code_information": [
        {
          "code": "PX-32000036",
          "type": "CDM"
        },
        {
          "code": "72050",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 459,
          "discounted_cash": 298.35,
          "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": 294.68
            },
            {
              "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": 371.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "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": 290.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 390.15
            },
            {
              "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": 402.54
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 95.95,
              "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": 96.91,
              "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": 380.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 380.51
            },
            {
              "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": 402.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 97.91,
              "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": 376.38
            },
            {
              "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": 95.95,
              "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": 294.68
            },
            {
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.91,
              "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": 390.15
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 95.95,
              "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": 459,
              "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": 97.91,
              "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": 290.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 97.91,
              "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": 390.15
            },
            {
              "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": 298.35
            },
            {
              "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": 294.68
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 254.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 459,
              "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": 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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "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": 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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 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 OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "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": "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": "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": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "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": 254.75
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 459,
              "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": 96.91,
              "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": 252.45
            },
            {
              "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": 459,
              "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": 298.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "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": 100.75,
              "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": 290.09
            },
            {
              "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 459,
              "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": 459,
              "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": 254.75
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "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": 96.91,
              "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": 96.91,
              "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": 290.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 459,
              "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": 335.07
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "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": 294.68
            },
            {
              "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": "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": "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
            },
            {
              "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": 459,
              "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": 459,
              "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": 459,
              "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": 459,
              "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": 335.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 459,
              "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": 403.92
            },
            {
              "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 100.75,
              "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": 380.51
            },
            {
              "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": 390.15
            },
            {
              "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": 298.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 95.95,
              "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": 459
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 100.75,
              "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": 344.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Thoracic Spine 2 Vw",
      "code_information": [
        {
          "code": "PX-32000039",
          "type": "CDM"
        },
        {
          "code": "72070",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 331,
          "discounted_cash": 215.15,
          "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": 212.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 271.42
            },
            {
              "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": 182.05
            },
            {
              "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": 100.75,
              "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": 212.5
            },
            {
              "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": 183.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 274.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 248.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 215.48
            },
            {
              "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": 271.42
            },
            {
              "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": 96.91,
              "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": 212.5
            },
            {
              "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": 291.28
            },
            {
              "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": 274.4
            },
            {
              "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": 97.91,
              "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": 271.42
            },
            {
              "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": 331,
              "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": 281.35
            },
            {
              "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": 331,
              "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": 281.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.05
            },
            {
              "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": 95.95,
              "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": 212.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 331
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 241.63
            },
            {
              "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": 290.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 241.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 215.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 248.25
            },
            {
              "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": 96.91,
              "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": 209.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 281.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 212.5
            },
            {
              "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": 212.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 281.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 209.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 100.75,
              "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": 215.48
            },
            {
              "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": 95.95,
              "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": 281.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 271.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 331,
              "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": 281.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 274.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 281.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 241.63
            },
            {
              "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": 97.91,
              "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": 212.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 183.71
            },
            {
              "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": 209.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 281.35
            },
            {
              "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": 183.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 271.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 281.35
            },
            {
              "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": 96.91,
              "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": 331,
              "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": 267.78
            },
            {
              "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": 95.95,
              "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": 271.42
            },
            {
              "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": 209.19
            },
            {
              "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": 331,
              "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": 96.91,
              "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": 331,
              "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": 290.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 212.5
            },
            {
              "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": 271.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.91,
              "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": 281.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 241.63
            },
            {
              "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": 241.63
            },
            {
              "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": 95.95,
              "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": 212.5
            },
            {
              "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": 267.78
            },
            {
              "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": 100.75,
              "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": 331,
              "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": 281.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 281.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 331,
              "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": 331,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 183.71
            },
            {
              "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": 331,
              "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": 212.5
            },
            {
              "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": 90.36
            },
            {
              "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": 281.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 209.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 241.63
            },
            {
              "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": 215.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 248.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 209.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 331,
              "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": 331,
              "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": 331,
              "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": 331,
              "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": 215.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 271.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 212.5
            },
            {
              "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": 215.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 209.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 97.91,
              "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": 281.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 331,
              "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": 209.19
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Swallowing Function Contrast Study",
      "code_information": [
        {
          "code": "PX-32000106",
          "type": "CDM"
        },
        {
          "code": "74230",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 403,
          "discounted_cash": 261.95,
          "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": 258.73
            },
            {
              "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": 161.96,
              "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": 403,
              "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": 334.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 302.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "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": 223.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.46
            },
            {
              "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": 168.38,
              "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": 254.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 403,
              "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": 330.46
            },
            {
              "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": 168.38,
              "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": 403,
              "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": 160.36,
              "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": 334.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 258.73
            },
            {
              "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": 353.43
            },
            {
              "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": 261.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 302.25
            },
            {
              "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": 334.09
            },
            {
              "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": 258.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 342.55
            },
            {
              "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": 160.36,
              "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": 254.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 254.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.46
            },
            {
              "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": 330.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 342.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 254.7
            },
            {
              "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": 163.63,
              "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": 294.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "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": 160.36,
              "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": 354.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 326.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.35
            },
            {
              "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": 330.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 403
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 163.63,
              "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": 403,
              "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": 403,
              "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": 302.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "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": 403,
              "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": 258.73
            },
            {
              "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": 254.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 163.63,
              "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": 221.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 403,
              "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": 403,
              "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": 258.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.19
            },
            {
              "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": 254.7
            },
            {
              "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": 258.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "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": 161.96,
              "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": 403,
              "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": 403,
              "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": 258.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 258.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 403,
              "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": 294.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 254.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 403,
              "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": 262.35
            },
            {
              "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": 342.55
            },
            {
              "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": 110.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 258.73
            },
            {
              "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": 258.73
            },
            {
              "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": 262.35
            },
            {
              "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": 353.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 403,
              "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": 161.96,
              "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": 168.38,
              "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": 254.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 223.67
            },
            {
              "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": 223.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "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": 160.36,
              "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": 403,
              "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": 342.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 403,
              "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": 258.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 258.73
            },
            {
              "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": 342.55
            },
            {
              "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": 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": 326.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.55
            },
            {
              "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": 223.67
            },
            {
              "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": 161.96,
              "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": 161.96,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Small Intestine Double Contrast Study",
      "code_information": [
        {
          "code": "PX-32000115",
          "type": "CDM"
        },
        {
          "code": "74251",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 830,
          "discounted_cash": 539.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 532.86
            },
            {
              "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": 532.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 727.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 540.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 605.9
            },
            {
              "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": 705.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "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": 524.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 532.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 532.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "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": 532.86
            },
            {
              "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": 460.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 456.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 688.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 622.5
            },
            {
              "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": 671.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 680.6
            },
            {
              "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": 830,
              "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": 524.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 456.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 605.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 532.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 532.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 540.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 680.6
            },
            {
              "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": 539.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 688.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 456.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 671.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 456.5
            },
            {
              "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": 830,
              "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": 460.65
            },
            {
              "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": 705.5
            },
            {
              "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": 830,
              "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": 680.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 622.5
            },
            {
              "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": 532.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 532.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 524.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 524.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 456.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 532.86
            },
            {
              "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": 460.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 605.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "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": 460.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 456.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 830,
              "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": 456.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 680.6
            },
            {
              "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": 688.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 830,
              "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": 524.56
            },
            {
              "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": 680.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 830,
              "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": 705.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 540.33
            },
            {
              "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": 524.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 730.4
            },
            {
              "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": 226.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 524.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 540.33
            },
            {
              "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": 605.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 605.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 605.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 524.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 680.6
            },
            {
              "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": 680.6
            },
            {
              "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": 830,
              "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": 830,
              "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": 830,
              "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": 727.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 830,
              "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": 532.86
            },
            {
              "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": 532.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 705.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 830
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 830,
              "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": 830,
              "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": 540.33
            },
            {
              "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": 680.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 622.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Lymphangiogram Pelvic Abdominal Bilateral",
      "code_information": [
        {
          "code": "PX-32000148",
          "type": "CDM"
        },
        {
          "code": "75807",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4458,
          "discounted_cash": 2897.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4458
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3923.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3606.52
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2451.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3789.3
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "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": 2817.46
            },
            {
              "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": 3254.34
            },
            {
              "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": 4458,
              "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": 4458,
              "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": 4458,
              "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": 2451.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2474.19
            },
            {
              "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": 4458,
              "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": 4458,
              "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": 4458,
              "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": 2902.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "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": 1217.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 2474.19
            },
            {
              "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": 2474.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3695.68
            },
            {
              "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": 3606.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 3909.67
            },
            {
              "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": 3789.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3695.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 2902.16
            },
            {
              "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": 2902.16
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3695.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3254.34
            },
            {
              "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": 2897.7
            },
            {
              "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": 2817.46
            },
            {
              "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": 4458,
              "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": 4458,
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "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": 3909.67
            },
            {
              "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": 2474.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4458,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Bone Age Studies",
      "code_information": [
        {
          "code": "PX-32000209",
          "type": "CDM"
        },
        {
          "code": "77072",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 314,
          "discounted_cash": 204.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 201.59
            },
            {
              "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": 266.9
            },
            {
              "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": 100.75,
              "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": 95.84,
              "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": 314,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 260.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 257.48
            },
            {
              "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": 98.62,
              "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": 198.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 235.5
            },
            {
              "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": 204.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.7
            },
            {
              "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": 93.93,
              "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": 266.9
            },
            {
              "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": 314,
              "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": 266.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.9
            },
            {
              "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": 204.41
            },
            {
              "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": 198.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 172.7
            },
            {
              "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": 96.91,
              "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": 257.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 204.41
            },
            {
              "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": 93.93,
              "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": 198.45
            },
            {
              "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": 275.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 276.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 229.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 266.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 229.22
            },
            {
              "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": 314,
              "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": 85.72
            },
            {
              "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": 266.9
            },
            {
              "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": 174.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 201.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 314
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 198.45
            },
            {
              "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": 95.84,
              "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": 266.9
            },
            {
              "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": 93.93,
              "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": 172.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 201.59
            },
            {
              "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": 201.59
            },
            {
              "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": 201.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 204.41
            },
            {
              "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": 257.48
            },
            {
              "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": 198.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 260.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 201.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 198.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 229.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 100.75,
              "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": 174.27
            },
            {
              "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": 254.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 257.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 201.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.9
            },
            {
              "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": 96.91,
              "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": 95.84,
              "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": 254.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 257.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 314,
              "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": 257.48
            },
            {
              "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": 314,
              "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": 229.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 235.5
            },
            {
              "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": 201.59
            },
            {
              "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": 93.93,
              "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": 314,
              "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": 204.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 198.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 229.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 198.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 201.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 201.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 201.59
            },
            {
              "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": 257.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 174.27
            },
            {
              "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": 275.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.9
            },
            {
              "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": 174.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 314,
              "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": 266.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 257.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.7
            },
            {
              "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": 96.91,
              "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": 96.91,
              "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": 235.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.9
            },
            {
              "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": 96.91,
              "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": 314,
              "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": 314,
              "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": 260.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 201.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 229.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 204.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 314,
              "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": 314,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Bone Density Dexa Axial",
      "code_information": [
        {
          "code": "PX-32000215",
          "type": "CDM"
        },
        {
          "code": "77080",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 446,
          "discounted_cash": 289.9,
          "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": 286.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 290.35
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 100.75,
              "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": 290.35
            },
            {
              "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": 121.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 325.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 446,
              "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": 379.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 379.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 379.1
            },
            {
              "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": 286.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 286.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 360.81
            },
            {
              "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": 391.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 379.1
            },
            {
              "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": 379.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 245.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 245.3
            },
            {
              "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": 96.91,
              "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": 247.53
            },
            {
              "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": 247.53
            },
            {
              "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": 290.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 446,
              "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": 392.48
            },
            {
              "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": 97.91,
              "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": 379.1
            },
            {
              "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": 446,
              "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": 95.95,
              "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": 446,
              "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": 286.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 286.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 290.35
            },
            {
              "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": 286.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 446,
              "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": 446,
              "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": 446,
              "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": 446,
              "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": 379.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 245.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 245.3
            },
            {
              "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": 281.87
            },
            {
              "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": 365.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 379.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 281.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 245.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 379.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 286.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 286.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 365.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 365.72
            },
            {
              "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": 100.75,
              "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": 286.33
            },
            {
              "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": 281.87
            },
            {
              "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": 245.3
            },
            {
              "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": 369.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 446,
              "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": 245.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 281.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 96.91,
              "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": 100.75,
              "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": 379.1
            },
            {
              "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": 365.72
            },
            {
              "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": 95.95,
              "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": 325.58
            },
            {
              "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": 446,
              "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": 369.73
            },
            {
              "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": 95.95,
              "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": 281.87
            },
            {
              "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": 281.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 379.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 281.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 325.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 446
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 360.81
            },
            {
              "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": 96.91,
              "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": 446,
              "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": 286.33
            },
            {
              "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": 290.35
            },
            {
              "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": 365.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 379.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 289.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 325.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 97.91,
              "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": 369.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 365.72
            },
            {
              "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": 96.91,
              "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": 446,
              "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": 446,
              "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": 286.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 365.72
            },
            {
              "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": 95.95,
              "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": 281.87
            },
            {
              "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": 96.91,
              "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": 391.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 334.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 365.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 247.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 334.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 446,
              "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": 97.91,
              "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": 379.1
            },
            {
              "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": 247.53
            },
            {
              "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": 325.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 325.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 334.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 379.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 286.33
            }
          ]
        }
      ]
    },
    {
      "description": "HC Aortogram Abdominal Serialogram",
      "code_information": [
        {
          "code": "PX-32300002",
          "type": "CDM"
        },
        {
          "code": "75625",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4458,
          "discounted_cash": 2897.7,
          "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": 2862.04
            },
            {
              "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": 2862.04
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 4458,
              "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": 3343.5
            },
            {
              "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": 3695.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 976.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "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": 2809.81,
              "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": 3789.3
            },
            {
              "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": 2902.16
            },
            {
              "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": 1217.03
            },
            {
              "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": 2817.46
            },
            {
              "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": 4458,
              "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": 2781.99,
              "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": 4458,
              "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": 2809.81,
              "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": 3789.3
            },
            {
              "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": 2902.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "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": 2897.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 2781.99,
              "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": 2781.99,
              "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": 3909.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 4458,
              "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": 3254.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "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": 2809.81,
              "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": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3655.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 2781.99,
              "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": 4458,
              "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": 3695.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "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": 2921.09,
              "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": 2817.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3695.68
            },
            {
              "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": 2778.76,
              "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": 2451.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "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": 2921.09,
              "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": 2862.04
            },
            {
              "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": 2809.81,
              "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": 4458,
              "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": 3923.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 4458,
              "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": 3606.52
            },
            {
              "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": 2921.09,
              "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": 2451.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2474.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3606.52
            },
            {
              "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": 3655.56
            },
            {
              "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": 4458,
              "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": 2862.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4458
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 2778.76,
              "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": 2778.76,
              "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": 2809.81,
              "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": 2451.9
            },
            {
              "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": 3254.34
            },
            {
              "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": 2474.19
            },
            {
              "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": 4458,
              "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": 2817.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 2474.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3909.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2474.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC Chemo Ivp Ea Addl Drug or Substance",
      "code_information": [
        {
          "code": "PX-33100005",
          "type": "CDM"
        },
        {
          "code": "96411",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 870,
          "discounted_cash": 565.5,
          "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": 558.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 558.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 635.1
            },
            {
              "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": 870,
              "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": 558.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 652.5
            },
            {
              "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": 703.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 713.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 870,
              "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": 762.99
            },
            {
              "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": 765.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 635.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 635.1
            },
            {
              "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": 62.74,
              "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": 549.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 870,
              "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": 558.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 558.54
            },
            {
              "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": 739.5
            },
            {
              "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": 549.84
            },
            {
              "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": 237.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 635.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 558.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 713.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 870,
              "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": 565.5
            },
            {
              "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": 558.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 478.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 635.1
            },
            {
              "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": 62.1,
              "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": 558.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 721.23
            },
            {
              "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": 713.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 713.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 478.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 558.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 703.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 478.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 721.23
            },
            {
              "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": 870,
              "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": 713.4
            },
            {
              "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": 482.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 739.5
            },
            {
              "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": 62.74,
              "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": 482.85
            },
            {
              "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": 870,
              "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": 549.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 566.37
            },
            {
              "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": 61.48,
              "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": 63.2,
              "estimated_amount": 549.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 739.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 478.5
            },
            {
              "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": 549.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 549.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 558.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 566.37
            },
            {
              "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": 64.56,
              "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": 482.85
            },
            {
              "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": 739.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "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": 762.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 870,
              "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": 566.37
            },
            {
              "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": 478.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 870
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.56,
              "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": 870,
              "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": 870,
              "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": 558.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 478.5
            },
            {
              "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": 721.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 739.5
            },
            {
              "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": 61.48,
              "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": 62.1,
              "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": 549.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 558.54
            },
            {
              "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": 566.37
            },
            {
              "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": 713.4
            },
            {
              "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": 482.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 652.5
            },
            {
              "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": 62.1,
              "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": 61.48,
              "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": 870,
              "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": 713.4
            },
            {
              "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": 61.48,
              "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": 870,
              "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": 870,
              "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": 870,
              "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": 549.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 62.74,
              "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": 739.5
            },
            {
              "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": 635.1
            },
            {
              "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": 566.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 478.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 870,
              "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": 62.1,
              "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": 64.56,
              "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": 870,
              "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": 739.5
            },
            {
              "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": 62.1,
              "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": 713.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 652.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Imrt Planning",
      "code_information": [
        {
          "code": "PX-33300007",
          "type": "CDM"
        },
        {
          "code": "77301",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 19984,
          "discounted_cash": 12989.6,
          "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": 12829.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10991.2
            },
            {
              "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": 1221.44,
              "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": 19984,
              "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": 19984,
              "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": 19984,
              "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": 14588.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19984,
              "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": 12829.73
            },
            {
              "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": 16386.88
            },
            {
              "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": 12629.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16986.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10991.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14588.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16986.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13009.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16386.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19984,
              "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": 19984,
              "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": 12829.73
            },
            {
              "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": 1234.03,
              "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": 19984,
              "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": 10991.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16386.88
            },
            {
              "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": 12829.73
            },
            {
              "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": 12629.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1234.03,
              "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": 10991.2
            },
            {
              "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": 19984,
              "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": 1269.82,
              "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": 1269.82,
              "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": 12629.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19984,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 4376.5
            },
            {
              "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": 1209.35,
              "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": 19984
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1209.35,
              "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": 11091.12
            },
            {
              "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": 17525.97
            },
            {
              "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": 12989.6
            },
            {
              "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": 12829.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12829.73
            },
            {
              "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": 16167.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12829.73
            },
            {
              "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": 17525.97
            },
            {
              "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": 1234.03,
              "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": 19984,
              "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": 19984,
              "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": 16986.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16986.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13009.58
            },
            {
              "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": 16566.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14588.32
            },
            {
              "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": 17585.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19984,
              "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": 19984,
              "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": 16986.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16986.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13009.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16386.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10991.2
            },
            {
              "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": 1221.44,
              "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": 12629.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16986.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11091.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14588.32
            },
            {
              "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": 1209.35,
              "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": 19984,
              "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": 19984,
              "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": 12829.73
            },
            {
              "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": 19984,
              "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": 19984,
              "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": 16986.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16566.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10991.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16566.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12629.89
            },
            {
              "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": 11091.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16986.4
            },
            {
              "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": 16386.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14988
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16167.06
            },
            {
              "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": 1209.35,
              "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": 16986.4
            },
            {
              "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": 1221.44,
              "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": 16386.88
            },
            {
              "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": 5455.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14988
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12629.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12829.73
            },
            {
              "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": 12829.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12829.73
            },
            {
              "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": 13009.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19984,
              "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": 19984,
              "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": 14588.32
            },
            {
              "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": 1221.44,
              "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": 16986.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12629.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12629.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19984,
              "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": 16986.4
            },
            {
              "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": 12829.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16386.88
            },
            {
              "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": 1221.44,
              "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": 19984,
              "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": 14988
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16986.4
            },
            {
              "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": 11091.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10991.2
            },
            {
              "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": 16986.4
            },
            {
              "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": 13009.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19984,
              "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": 16386.88
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1269.82,
              "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": 14588.32
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hepatobiliary System Imaging",
      "code_information": [
        {
          "code": "PX-34100019",
          "type": "CDM"
        },
        {
          "code": "78226",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3197,
          "discounted_cash": 2078.05,
          "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": 2052.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2081.25
            },
            {
              "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": 2621.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2020.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2020.5
            },
            {
              "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": 367.32,
              "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": 2717.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "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": 2052.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2052.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2052.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "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": 359.97,
              "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": 3197,
              "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": 359.97,
              "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": 2717.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2621.54
            },
            {
              "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": 2813.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1774.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2397.75
            },
            {
              "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": 2333.81
            },
            {
              "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": 363.57,
              "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": 2717.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2020.5
            },
            {
              "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": 2803.77
            },
            {
              "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": 3197,
              "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": 2020.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 367.32,
              "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": 700.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1758.35
            },
            {
              "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": 2052.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "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": 2078.05
            },
            {
              "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": 1774.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 3197,
              "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": 3197,
              "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": 3197,
              "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": 377.97,
              "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": 2586.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2081.25
            },
            {
              "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": 377.97,
              "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": 2717.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2333.81
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3197,
              "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": 2717.45
            },
            {
              "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": 2081.25
            },
            {
              "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": 359.97,
              "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": 1758.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 3197,
              "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": 2333.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 3197,
              "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": 2333.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2052.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2650.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 3197,
              "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": 363.57,
              "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": 3197,
              "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": 3197,
              "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": 3197,
              "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": 363.57,
              "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": 2621.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2621.54
            },
            {
              "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": 377.97,
              "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": 2650.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2052.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2052.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1758.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2020.5
            },
            {
              "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": 1774.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3197
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2020.5
            },
            {
              "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": 2586.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 363.57,
              "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": 1758.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2052.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 2397.75
            },
            {
              "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": 363.57,
              "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": 3197,
              "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": 2621.54
            },
            {
              "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": 2020.5
            },
            {
              "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": 3197,
              "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": 2052.47
            },
            {
              "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": 872.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1758.35
            },
            {
              "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": 1774.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1758.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1758.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 2052.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2621.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2081.25
            },
            {
              "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": 359.97,
              "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": 2717.45
            },
            {
              "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": 2020.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3197,
              "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": 2803.77
            },
            {
              "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": 2081.25
            },
            {
              "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": 2650.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2333.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2052.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2621.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2621.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2717.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2333.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2397.75
            },
            {
              "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": 367.32,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Sterile Water Nebulizer 1000ml Prefilled for Inhalatio",
      "code_information": [
        {
          "code": "PX-CH-55CN0010",
          "type": "CDM"
        },
        {
          "code": "A4217",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.3,
          "discounted_cash": 2.79,
          "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": 2.76
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 4.3,
              "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": 2.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "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": "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": "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": "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 OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 2.76
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 4.3,
              "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": 4.3,
              "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": 4.3,
              "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": 3.23
            },
            {
              "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": 2.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 3.66
            },
            {
              "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 3.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.3,
              "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": 4.3,
              "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": 4.3,
              "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": 2.76
            },
            {
              "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": "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": "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 PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 3.66
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "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": 2.76
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "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": "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
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 2.76
            },
            {
              "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": 2.39
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.48
            },
            {
              "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": 2.72
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.8
            },
            {
              "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": 3.53
            },
            {
              "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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.3,
              "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": 2.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 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": 3.53
            },
            {
              "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": "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.3,
              "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": 3.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.56
            },
            {
              "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": 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": 4.3,
              "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": 4.3,
              "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": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.3,
              "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": 2.72
            },
            {
              "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": 3.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "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": 2.8
            },
            {
              "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": "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": "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": "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": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.48
            },
            {
              "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": "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": "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": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            }
          ]
        }
      ]
    },
    {
      "description": "HC Noncardiac Vascular Flow Imaging",
      "code_information": [
        {
          "code": "PX-34100033",
          "type": "CDM"
        },
        {
          "code": "78445",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1026,
          "discounted_cash": 666.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 658.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 769.5
            },
            {
              "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": 648.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 648.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 569.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 658.69
            },
            {
              "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": 569.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1026
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 850.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 850.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 748.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 658.69
            },
            {
              "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": 1026,
              "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": 658.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 830.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 748.98
            },
            {
              "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": 899.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 872.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 769.5
            },
            {
              "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": 872.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 658.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 648.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 1026,
              "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": 872.1
            },
            {
              "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": 1026,
              "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": 667.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 841.32
            },
            {
              "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": 841.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 648.43
            },
            {
              "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": 564.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 666.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 1026,
              "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": 658.69
            },
            {
              "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": 658.69
            },
            {
              "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": 830.03
            },
            {
              "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": 841.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 872.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 841.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 648.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 564.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 564.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 769.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 748.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 872.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 748.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 872.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 667.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 748.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 872.1
            },
            {
              "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": 280.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 872.1
            },
            {
              "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": 902.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 658.69
            },
            {
              "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": 658.69
            },
            {
              "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": 667.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 872.1
            },
            {
              "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": 872.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 1026,
              "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": 850.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 667.93
            },
            {
              "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": 667.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 564.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 564.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 648.43
            },
            {
              "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": 748.98
            },
            {
              "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": 1026,
              "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": 1026,
              "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": 841.32
            },
            {
              "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": 658.69
            },
            {
              "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": 658.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 872.1
            },
            {
              "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": 569.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 564.3
            },
            {
              "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": 1026,
              "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": 841.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 841.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1026,
              "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": 648.43
            },
            {
              "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": 899.8
            },
            {
              "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": 648.43
            },
            {
              "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": 569.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 841.32
            },
            {
              "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": 1026,
              "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": 564.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1026,
              "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": 1026,
              "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": 658.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 872.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Brain Imaging 4+ Static Views",
      "code_information": [
        {
          "code": "PX-34100053",
          "type": "CDM"
        },
        {
          "code": "78605",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1932,
          "discounted_cash": 1255.8,
          "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": 1240.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1642.2
            },
            {
              "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": 1221.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1062.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1410.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1449
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1642.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1642.2
            },
            {
              "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": 1062.6
            },
            {
              "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": 1932,
              "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": 1584.24
            },
            {
              "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": 1240.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1584.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1642.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1257.73
            },
            {
              "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": 1694.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1449
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1932,
              "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": 1642.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1240.34
            },
            {
              "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": 1257.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1932,
              "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": 1240.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1700.16
            },
            {
              "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": 1584.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1584.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1257.73
            },
            {
              "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": 1257.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1062.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1410.36
            },
            {
              "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": 1240.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1240.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1932
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1062.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1410.36
            },
            {
              "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": 1240.34
            },
            {
              "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": 1072.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1221.02
            },
            {
              "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": 1932,
              "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": 1932,
              "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": 1932,
              "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": 1642.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1072.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1601.63
            },
            {
              "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": 1584.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1584.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1562.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1221.02
            },
            {
              "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": 1932,
              "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": 1410.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1642.2
            },
            {
              "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": 1255.8
            },
            {
              "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": 1932,
              "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": 1694.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1062.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1410.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1642.2
            },
            {
              "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": 1932,
              "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": 1642.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1240.34
            },
            {
              "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": 527.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1601.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1932,
              "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": 1221.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1221.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1642.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1562.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1221.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1584.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1449
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1932,
              "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": 1410.36
            },
            {
              "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": 1221.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1221.02
            },
            {
              "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": 1072.26
            },
            {
              "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": 1601.63
            },
            {
              "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": 1240.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1257.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1642.2
            },
            {
              "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": 1072.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1062.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1062.6
            },
            {
              "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": 1584.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1642.2
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Ctf Std Wear Up to 2 1/4 in New Image",
      "code_information": [
        {
          "code": "PX-CH-HO14204",
          "type": "CDM"
        },
        {
          "code": "A4414",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.74,
          "discounted_cash": 1.78,
          "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": 1.76
            },
            {
              "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": 2.33
            },
            {
              "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": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 2.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "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": 2.74,
              "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": 1.76
            },
            {
              "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": 2.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 1.78
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.74,
              "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": 1.52
            },
            {
              "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": 1.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 1.51
            },
            {
              "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": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 2.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 2.74,
              "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": 2.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "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": 2.74,
              "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": 2.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "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": 1.52
            },
            {
              "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": 2.74,
              "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": 1.51
            },
            {
              "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": 1.73
            },
            {
              "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": 1.78
            },
            {
              "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": 2.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.52
            },
            {
              "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": 2.74,
              "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": 2.33
            },
            {
              "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": 2.74,
              "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": 1.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.33
            },
            {
              "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": 1.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 1.78
            },
            {
              "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": 2.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 2.33
            },
            {
              "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": 2.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.33
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "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": 2.74,
              "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": 2.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.76
            },
            {
              "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": 2.74,
              "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": 2.74,
              "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": 2.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 2.74,
              "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": 2.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.74,
              "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": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.73
            },
            {
              "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": 1.78
            },
            {
              "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": 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": 1.73
            },
            {
              "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": 2.74,
              "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": 2.74,
              "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
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.27
            },
            {
              "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": 1.76
            },
            {
              "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": 2.22
            },
            {
              "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": 0.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.73
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.25
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.78
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.74,
              "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": 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": 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": 2.4
            },
            {
              "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": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.74,
              "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": 2.74,
              "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": 1.52
            },
            {
              "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": 1.76
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            }
          ]
        }
      ]
    },
    {
      "description": "HC Peri-Proc Device Eval and Program Implantable Defibrillator",
      "code_information": [
        {
          "code": "PX-48000071",
          "type": "CDM"
        },
        {
          "code": "93287",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 316,
          "discounted_cash": 205.4,
          "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": 202.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 316,
              "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": 199.71
            },
            {
              "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": 268.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 173.8
            },
            {
              "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": 259.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 259.12
            },
            {
              "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": 259.12
            },
            {
              "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": 316,
              "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": 316,
              "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": 173.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 202.87
            },
            {
              "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": 277.13
            },
            {
              "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": 175.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 173.8
            },
            {
              "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": 175.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 202.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 259.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 230.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 255.64
            },
            {
              "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": 175.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 199.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 173.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 237
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 277.13
            },
            {
              "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": 316,
              "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": 316,
              "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": 268.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 316,
              "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": 202.87
            },
            {
              "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": 205.72
            },
            {
              "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": 255.64
            },
            {
              "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": 199.71
            },
            {
              "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": 261.96
            },
            {
              "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": 205.4
            },
            {
              "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": 199.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 268.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 230.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 268.6
            },
            {
              "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": 268.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 230.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 202.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 173.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 202.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 259.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 259.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 268.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 199.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 316,
              "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": 278.08
            },
            {
              "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": 202.87
            },
            {
              "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": 230.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 173.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 205.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 175.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 202.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 259.12
            },
            {
              "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": 202.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 199.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 316,
              "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": 237
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 199.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 316,
              "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": 316
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 230.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 230.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 199.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 259.12
            },
            {
              "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": 173.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 205.72
            },
            {
              "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": 86.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 316,
              "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": 316,
              "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": 316,
              "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": 261.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 261.96
            },
            {
              "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": 202.87
            },
            {
              "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": 205.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 205.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "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": 202.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 202.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 237
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 316,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC CT Guided Radiother Fields Plcmnt",
      "code_information": [
        {
          "code": "PX-35000007",
          "type": "CDM"
        },
        {
          "code": "77014",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2541,
          "discounted_cash": 1651.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "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": 1860.01
            },
            {
              "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": 1867.64
            },
            {
              "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": 1654.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1397.55
            },
            {
              "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": 1860.01
            },
            {
              "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": 1867.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1397.55
            },
            {
              "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": 2541,
              "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": 2541,
              "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": 2083.62
            },
            {
              "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": 2083.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2159.85
            },
            {
              "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": 2159.85
            },
            {
              "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": 1870.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1860.01
            },
            {
              "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": 693.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2541,
              "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": 2106.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1397.55
            },
            {
              "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": 2159.85
            },
            {
              "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": 1654.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2541,
              "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": 2541,
              "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": 2159.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2083.62
            },
            {
              "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": 1397.55
            },
            {
              "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": 1867.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2541,
              "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": 2159.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2159.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1905.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2106.49
            },
            {
              "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": 1870.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1854.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1854.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2159.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2541,
              "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": 2541
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1397.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1854.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1860.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2159.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2541,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 556.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2083.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2541,
              "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": 2541,
              "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": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2083.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1854.93
            },
            {
              "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": 2541,
              "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": 2541,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1654.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1654.19
            },
            {
              "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": 2541,
              "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": 2083.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2083.62
            },
            {
              "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": 2083.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2159.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "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": 2541,
              "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": 2159.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1867.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2055.67
            },
            {
              "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": 2055.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2159.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2106.49
            },
            {
              "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": 1854.93
            },
            {
              "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": 2541,
              "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": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "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": 2541,
              "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": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2159.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2236.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1860.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2159.85
            },
            {
              "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": 2541,
              "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": 2159.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1905.75
            },
            {
              "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": 1860.01
            },
            {
              "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": 2228.46
            },
            {
              "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": 2541,
              "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": 73.2,
              "estimated_amount": 1860.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 1654.19
            },
            {
              "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": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1905.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2541,
              "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": 2541,
              "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": 1397.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1854.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1870.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1397.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1860.01
            },
            {
              "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": 2228.46
            },
            {
              "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": 2541,
              "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": 2541,
              "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": 1651.65
            },
            {
              "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": 2541,
              "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": 2541,
              "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": 2541,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Diagnostic Chest CT Without Contrast",
      "code_information": [
        {
          "code": "PX-35200001",
          "type": "CDM"
        },
        {
          "code": "71250",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1333,
          "discounted_cash": 866.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 981.09
            },
            {
              "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": 975.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1105.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1133.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1133.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 981.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1093.06
            },
            {
              "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": 979.76
            },
            {
              "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": 1333,
              "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": 1105.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 999.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 981.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1333,
              "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": 73.6,
              "estimated_amount": 981.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 975.76
            },
            {
              "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": 96.91,
              "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": 1333
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1093.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 975.76
            },
            {
              "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": 97.91,
              "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": 1133.05
            },
            {
              "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": 866.45
            },
            {
              "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": 100.75,
              "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": 973.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 733.15
            },
            {
              "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": 867.78
            },
            {
              "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": 1093.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1333,
              "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": 973.09
            },
            {
              "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": 100.75,
              "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": 1093.06
            },
            {
              "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": 73.6,
              "estimated_amount": 981.09
            },
            {
              "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": 975.76
            },
            {
              "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": 291.93
            },
            {
              "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": 1333,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 733.15
            },
            {
              "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": 1078.4
            },
            {
              "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": 96.91,
              "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": 1333,
              "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": 1133.05
            },
            {
              "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": 100.75,
              "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": 73.6,
              "estimated_amount": 981.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 973.09
            },
            {
              "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": 1333,
              "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": 1333,
              "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": 1133.05
            },
            {
              "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": 95.95,
              "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": 73.6,
              "estimated_amount": 981.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 733.15
            },
            {
              "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": 1133.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1133.05
            },
            {
              "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": 1169.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 73.6,
              "estimated_amount": 981.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 979.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1133.05
            },
            {
              "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": 867.78
            },
            {
              "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": 95.95,
              "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": 973.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1105.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1133.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 981.09
            },
            {
              "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": 95.95,
              "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": 733.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 973.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1133.05
            },
            {
              "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": 981.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1078.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 733.15
            },
            {
              "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": 1169.04
            },
            {
              "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": 97.91,
              "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": 867.78
            },
            {
              "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": 96.91,
              "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": 1093.06
            },
            {
              "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": 363.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 975.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 973.09
            },
            {
              "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": 1333,
              "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": 1093.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 981.09
            },
            {
              "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": 979.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1133.05
            },
            {
              "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": 981.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 867.78
            },
            {
              "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": 95.95,
              "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": 999.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1133.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 96.91,
              "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": 1093.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1133.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 999.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 975.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 733.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 867.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1093.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 1173.04
            },
            {
              "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": 979.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1333,
              "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": 733.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 975.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 73.2,
              "estimated_amount": 975.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1333,
              "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": 97.91,
              "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": 1133.05
            },
            {
              "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": 96.91,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cta Chest W WO Contrast",
      "code_information": [
        {
          "code": "PX-35200004",
          "type": "CDM"
        },
        {
          "code": "71275",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1895,
          "discounted_cash": 1231.75,
          "payers_information": [
            {
              "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": 1394.72
            },
            {
              "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": 161.96,
              "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": 1895,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "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": 160.36,
              "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": 1042.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.9
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1895,
              "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": 1895,
              "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": 1895,
              "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": 1610.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1042.25
            },
            {
              "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": 160.36,
              "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": 1570.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "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": 1553.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1387.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1383.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1421.25
            },
            {
              "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": 1553.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1387.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 161.96,
              "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": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1387.14
            },
            {
              "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": 163.63,
              "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": 1610.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1387.14
            },
            {
              "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": 1667.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1570.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1042.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1233.65
            },
            {
              "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": 1392.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "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": 168.38,
              "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": 1661.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1392.83
            },
            {
              "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": 1383.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1895
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "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": 168.38,
              "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": 1610.75
            },
            {
              "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": 1387.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 1042.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.9
            },
            {
              "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": 1233.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 163.63,
              "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": 1383.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "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": 1387.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 163.63,
              "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": 1553.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "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": 160.36,
              "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": 1895,
              "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": 1383.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 1042.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1042.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1233.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 161.96,
              "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": 1895,
              "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": 1610.75
            },
            {
              "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": 1533.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1533.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 1570.96
            },
            {
              "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": 161.96,
              "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": 73.2,
              "estimated_amount": 1387.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "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": 1394.72
            },
            {
              "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": 517.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 1392.83
            },
            {
              "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": 1895,
              "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": 1610.75
            },
            {
              "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": 1392.83
            },
            {
              "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": 1233.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1383.35
            },
            {
              "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": 1895,
              "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": 160.36,
              "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": 168.38,
              "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": 1394.72
            },
            {
              "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": 73.6,
              "estimated_amount": 1394.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1421.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 1610.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.9
            },
            {
              "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": 1394.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1233.65
            },
            {
              "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": 1895,
              "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": 1661.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 1895,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 415.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1421.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1042.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "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": 161.96,
              "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": 1231.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1610.75
            },
            {
              "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": 1387.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1383.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1895,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC CT Thoracic Spine WO Contrast",
      "code_information": [
        {
          "code": "PX-35200008",
          "type": "CDM"
        },
        {
          "code": "72128",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1117,
          "discounted_cash": 726.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 822.11
            },
            {
              "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": 95.95,
              "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": 97.91,
              "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": 949.45
            },
            {
              "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": 821
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1117,
              "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": 727.17
            },
            {
              "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": 95.95,
              "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": 903.65
            },
            {
              "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": 915.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 949.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 837.75
            },
            {
              "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": 949.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 1117,
              "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": 949.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 614.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 949.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1117
            },
            {
              "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": 822.11
            },
            {
              "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": 817.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 614.35
            },
            {
              "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": 822.11
            },
            {
              "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": 817.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 1117,
              "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": 1117,
              "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": 815.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 949.45
            },
            {
              "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": 982.96
            },
            {
              "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": 96.91,
              "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": 949.45
            },
            {
              "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": 614.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 815.41
            },
            {
              "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": 821
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 915.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 97.91,
              "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": 949.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 915.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 817.64
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 949.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 614.35
            },
            {
              "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": 100.75,
              "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": 73.6,
              "estimated_amount": 822.11
            },
            {
              "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": 95.95,
              "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": 96.91,
              "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": 1117,
              "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": 1117,
              "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": 73.5,
              "estimated_amount": 821
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 949.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 815.41
            },
            {
              "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": 96.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 817.64
            },
            {
              "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": 1117,
              "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": 915.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 915.94
            },
            {
              "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": 96.91,
              "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": 915.94
            },
            {
              "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": 925.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 925.99
            },
            {
              "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": 100.75,
              "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": 73.2,
              "estimated_amount": 817.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 100.75,
              "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": 244.62
            },
            {
              "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": 822.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 815.41
            },
            {
              "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": 1117,
              "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": 949.45
            },
            {
              "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": 949.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 1117,
              "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": 726.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 817.64
            },
            {
              "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": 817.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 1117,
              "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": 97.91,
              "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": 727.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 822.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 915.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 949.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 949.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 614.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 837.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 73.6,
              "estimated_amount": 822.11
            },
            {
              "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": 915.94
            },
            {
              "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": 815.41
            },
            {
              "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": 821
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 925.99
            },
            {
              "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": 979.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1117,
              "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": 1117,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 822.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.17
            },
            {
              "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": 979.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 614.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 815.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 614.35
            },
            {
              "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": 822.11
            },
            {
              "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": 903.65
            },
            {
              "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": 96.91,
              "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": 1117,
              "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": 73.6,
              "estimated_amount": 822.11
            },
            {
              "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": 95.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 822.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 817.64
            },
            {
              "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": 304.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 822.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 837.75
            }
          ]
        }
      ]
    },
    {
      "description": "Insert Left Vad Arterial & Venous Access Percutaneous W/ Img",
      "code_information": [
        {
          "code": "PX-36000054",
          "type": "CDM"
        },
        {
          "code": "33991",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1405,
          "discounted_cash": 913.25,
          "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": 902.01
            },
            {
              "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": 914.66
            },
            {
              "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": 1152.1
            },
            {
              "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": 1025.65
            },
            {
              "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": 913.25
            },
            {
              "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": 887.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1405
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1405,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "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": 1152.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1405,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1405,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1405,
              "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": 1053.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 914.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "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": 772.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "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": 902.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1164.75
            },
            {
              "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": 1194.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "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": 383.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1053.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "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": 1405,
              "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": 1194.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1405,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1405
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1405,
              "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": 887.96
            },
            {
              "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": 902.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "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": 902.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1136.65
            },
            {
              "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": 914.66
            },
            {
              "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": 1152.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1405,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1405
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "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": 902.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "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": 887.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1405,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 914.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1164.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "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": 887.96
            },
            {
              "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": 1232.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1053.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1405
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1405,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1164.75
            },
            {
              "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": 1136.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1405
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1236.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 914.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "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": 1232.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC I and D Abscess Complicated",
      "code_information": [
        {
          "code": "PX-36100004",
          "type": "CDM"
        },
        {
          "code": "10061",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2059,
          "discounted_cash": 1338.35,
          "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": 1321.88
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1750.15
            },
            {
              "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": 2059,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1321.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1665.73
            },
            {
              "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": 2059,
              "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": 348.02,
              "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": 1805.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1301.29
            },
            {
              "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": 1301.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 2059,
              "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": 1750.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1301.29
            },
            {
              "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": 351.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1321.88
            },
            {
              "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": 1340.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 1750.15
            },
            {
              "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": 351.5,
              "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": 1750.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 1750.15
            },
            {
              "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": 1706.91
            },
            {
              "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": 355.12,
              "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": 1321.88
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 365.42,
              "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": 1340.41
            },
            {
              "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": 348.02,
              "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": 1338.35
            },
            {
              "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": 351.5,
              "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": 2059,
              "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": 1503.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1750.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2059
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2059,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 2059,
              "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": 1665.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1688.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1750.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 2059,
              "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": 1503.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2059
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1805.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1706.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1132.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1132.45
            },
            {
              "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": 1132.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1750.15
            },
            {
              "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": 1750.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 1321.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1301.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 1811.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1132.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1132.45
            },
            {
              "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": 351.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2059
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 365.42,
              "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": 1544.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 1750.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1544.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1132.45
            },
            {
              "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": 1321.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1688.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1301.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1301.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 1321.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1688.38
            },
            {
              "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": 1301.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 1321.88
            },
            {
              "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": 1688.38
            },
            {
              "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": 348.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1321.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1340.41
            },
            {
              "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": 1688.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1688.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1544.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1750.15
            },
            {
              "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": 1301.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1503.07
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2059,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2059
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1688.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1706.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 2059,
              "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": 1340.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1750.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1750.15
            },
            {
              "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": 1321.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1321.88
            },
            {
              "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": 1688.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2059,
              "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": 351.5,
              "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": 355.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2059
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1503.07
            },
            {
              "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": 365.42,
              "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": 2059,
              "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": 1321.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1340.41
            },
            {
              "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": 562.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1132.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1503.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1503.07
            },
            {
              "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": 348.02,
              "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": 355.12,
              "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": 1750.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC Trimming of Skin Lesion",
      "code_information": [
        {
          "code": "PX-36100019",
          "type": "CDM"
        },
        {
          "code": "11055",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 540,
          "discounted_cash": 351,
          "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": 346.68
            },
            {
              "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": 346.68
            },
            {
              "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": 183.47,
              "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": 540,
              "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": 174.53,
              "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": 459
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 540,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 351.54
            },
            {
              "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": 176.48,
              "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": 351.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 459
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 346.68
            },
            {
              "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": 174.53,
              "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": 447.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 346.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 346.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 442.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 147.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 346.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 540,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 540
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 171.04,
              "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": 540,
              "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": 540,
              "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": 297
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 436.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 176.48,
              "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": 540,
              "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": 540,
              "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": 459
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 442.8
            },
            {
              "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": 473.58
            },
            {
              "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": 341.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 540,
              "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": 394.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 540
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 540
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 540,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 405
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 442.8
            },
            {
              "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": 394.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 351.54
            },
            {
              "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": 341.28
            },
            {
              "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": 540,
              "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": 297
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 540,
              "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": 540,
              "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": 475.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 442.8
            },
            {
              "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": 176.48,
              "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": 183.47,
              "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": 341.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 459
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 171.04,
              "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": 171.04,
              "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": 174.53,
              "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": 341.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 459
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 346.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 171.04,
              "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": 297
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 442.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 459
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 473.58
            },
            {
              "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": 346.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 346.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 346.68
            },
            {
              "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": 442.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 436.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 540
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 176.48,
              "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": 540,
              "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": 459
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 405
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 540
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 341.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 394.2
            },
            {
              "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": 351.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 442.8
            },
            {
              "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": 179.59,
              "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": 447.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 442.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 447.66
            },
            {
              "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": 346.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 405
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.2
            },
            {
              "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": 176.48,
              "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": 346.68
            },
            {
              "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": 351.54
            },
            {
              "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": 341.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 540,
              "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": 351
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 297
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 459
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 394.2
            }
          ]
        }
      ]
    },
    {
      "description": "HC Avulsion Nail Plate Single",
      "code_information": [
        {
          "code": "PX-36100029",
          "type": "CDM"
        },
        {
          "code": "11730",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 898,
          "discounted_cash": 583.7,
          "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": 576.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 576.52
            },
            {
              "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": 584.6
            },
            {
              "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": 655.54
            },
            {
              "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": 176.48,
              "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": 567.54
            },
            {
              "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": 174.53,
              "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": 174.53,
              "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": 763.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 898,
              "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": 576.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 567.54
            },
            {
              "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": 567.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 898,
              "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": 183.47,
              "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": 898,
              "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": 493.9
            },
            {
              "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": 763.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 726.48
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 898,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 176.48,
              "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": 576.52
            },
            {
              "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": 584.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 736.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 493.9
            },
            {
              "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": 898,
              "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": 736.36
            },
            {
              "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": 179.59,
              "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": 673.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 763.3
            },
            {
              "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": 171.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 898
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 790.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 567.54
            },
            {
              "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": 736.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 736.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 655.54
            },
            {
              "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": 176.48,
              "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": 576.52
            },
            {
              "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": 171.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 898
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 493.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 567.54
            },
            {
              "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": 174.53,
              "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": 763.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 584.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 736.36
            },
            {
              "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": 245.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 763.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 898,
              "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": 744.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 673.5
            },
            {
              "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": 576.52
            },
            {
              "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": 567.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 763.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 763.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 744.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 744.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 493.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 898
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 736.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 898,
              "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": 493.9
            },
            {
              "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": 787.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 673.5
            },
            {
              "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": 898,
              "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": 898,
              "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": 763.3
            },
            {
              "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": 583.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 576.52
            },
            {
              "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": 898,
              "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": 171.04,
              "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": 176.48,
              "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": 763.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 576.52
            },
            {
              "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": 576.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 898
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 898,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 763.3
            },
            {
              "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": 898,
              "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": 171.04,
              "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": 763.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 576.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 763.3
            },
            {
              "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": 576.52
            },
            {
              "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": 736.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 493.9
            },
            {
              "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": 176.48,
              "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": 763.3
            },
            {
              "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": 183.47,
              "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": 567.54
            },
            {
              "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": 787.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 763.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 898
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 584.6
            },
            {
              "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": 736.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 576.52
            },
            {
              "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": 726.48
            },
            {
              "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": 567.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 898,
              "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": 584.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 493.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC Inj Trigger Point 3 or More Muscles",
      "code_information": [
        {
          "code": "PX-36100083",
          "type": "CDM"
        },
        {
          "code": "20553",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2608,
          "discounted_cash": 1695.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1697.81
            },
            {
              "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": 1648.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2216.8
            },
            {
              "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": 1695.2
            },
            {
              "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": 2295.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1956
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "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": 2608,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1956
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "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": 2216.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 258.5,
              "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": 258.5,
              "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": 2162.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 2216.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "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": 271.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1697.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1903.84
            },
            {
              "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": 1674.34
            },
            {
              "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": 261.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1674.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "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": 1697.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 1434.4
            },
            {
              "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": 258.5,
              "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": 1648.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "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": 2608,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1434.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2162.03
            },
            {
              "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": 2608,
              "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": 258.5,
              "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": 2608,
              "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": 1903.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "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": 263.78,
              "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": 2216.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1903.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2608,
              "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": 2608,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2162.03
            },
            {
              "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": 261.09,
              "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": 271.43,
              "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": 1674.34
            },
            {
              "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": 2608,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 423
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 2287.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 1697.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1697.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1956
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 263.78,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1903.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2109.87
            },
            {
              "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": 2109.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2608,
              "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": 2608,
              "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": 2216.8
            },
            {
              "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": 2608,
              "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": 1903.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2138.56
            },
            {
              "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": 261.09,
              "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": 1903.84
            },
            {
              "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": 261.09,
              "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": 2608,
              "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": 2138.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1434.4
            },
            {
              "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": 271.43,
              "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": 1674.34
            },
            {
              "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": 1674.34
            },
            {
              "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": 1674.34
            },
            {
              "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": 2138.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "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": 2287.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 263.78,
              "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": 1674.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "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": 711.98
            },
            {
              "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": 1648.26
            },
            {
              "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": 261.09,
              "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": 2608,
              "additional_payer_notes": " ASC LISTED"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Asp or Inj Joint Large",
      "code_information": [
        {
          "code": "PX-36100086",
          "type": "CDM"
        },
        {
          "code": "20610",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3109,
          "discounted_cash": 2020.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1995.98
            },
            {
              "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": 3109,
              "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": 2642.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 3109,
              "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": 3109,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2331.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2023.96
            },
            {
              "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": 2549.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1709.95
            },
            {
              "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": 2642.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2269.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 2515.18
            },
            {
              "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": 1995.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2331.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 2549.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1709.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2269.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2515.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 3109,
              "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": 1995.98
            },
            {
              "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": 1995.98
            },
            {
              "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": 1995.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1709.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1995.98
            },
            {
              "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": 2023.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2577.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 1964.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 2726.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2642.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1709.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2269.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1964.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2642.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2549.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1995.98
            },
            {
              "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": 2023.96
            },
            {
              "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": 3109,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2549.38
            },
            {
              "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": 2269.57
            },
            {
              "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": 3109,
              "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": 2577.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2549.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2549.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1964.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2269.57
            },
            {
              "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": 3109,
              "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": 1964.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 3109,
              "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": 1995.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 2642.65
            },
            {
              "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": 2735.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 3109,
              "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": 1995.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2549.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1964.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 3109,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1964.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3109,
              "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": 3109,
              "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": 2642.65
            },
            {
              "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": 2020.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1995.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1709.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1709.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1995.98
            },
            {
              "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": 848.76
            },
            {
              "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": 2642.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1995.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2642.65
            },
            {
              "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": 1964.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2642.65
            },
            {
              "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": 1709.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3109,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2331.75
            },
            {
              "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": 2549.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2577.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2642.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2023.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2023.96
            },
            {
              "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": 2726.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1964.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2269.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2642.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2642.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC Asp or Inj Ganglion Cyst",
      "code_information": [
        {
          "code": "PX-36100087",
          "type": "CDM"
        },
        {
          "code": "20612",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2219,
          "discounted_cash": 1442.35,
          "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": 1424.6
            },
            {
              "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": 1424.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1220.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1220.45
            },
            {
              "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": 258.2,
              "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": 2219,
              "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": 2219,
              "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": 2219,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1619.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1819.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 1619.87
            },
            {
              "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": 1402.41
            },
            {
              "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": 1402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 2219,
              "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": 261.09,
              "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": 271.43,
              "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": 1220.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1619.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1664.25
            },
            {
              "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": 1839.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "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": 2219,
              "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": 1220.45
            },
            {
              "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": 2219,
              "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": 1444.57
            },
            {
              "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": 605.79
            },
            {
              "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": 1424.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1444.57
            },
            {
              "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": 1795.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1220.45
            },
            {
              "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": 1402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 1442.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "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": 261.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2219
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2219
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2219
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1819.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1424.6
            },
            {
              "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": 258.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2219
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 2219,
              "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": 258.2,
              "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": 1946.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1619.87
            },
            {
              "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": 1819.58
            },
            {
              "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": 253.04,
              "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": 64.2,
              "estimated_amount": 1424.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1664.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 1444.57
            },
            {
              "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": 1819.58
            },
            {
              "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": 1946.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1220.45
            },
            {
              "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": 1886.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 2219,
              "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": 1886.15
            },
            {
              "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": 265.69,
              "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": 1424.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1444.57
            },
            {
              "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": 253.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2219
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1839.55
            },
            {
              "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": 2219,
              "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": 1795.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1819.58
            },
            {
              "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": 261.09,
              "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": 1402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 1886.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 1952.72
            },
            {
              "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": 1819.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1819.58
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1664.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1424.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1424.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1619.87
            },
            {
              "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": 261.09,
              "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": 1424.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1819.58
            },
            {
              "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": 1220.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1619.87
            },
            {
              "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": 261.09,
              "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": 253.04,
              "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": 253.04,
              "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": 2219,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2219,
              "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": 1424.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1424.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1424.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1839.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1886.15
            },
            {
              "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": 271.43,
              "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": 2219,
              "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": 1402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "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": 1444.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2219,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Vertebroplasty Ea Addl Thor or Lumb W Img",
      "code_information": [
        {
          "code": "PX-36100099",
          "type": "CDM"
        },
        {
          "code": "22512",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20118,
          "discounted_cash": 13076.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12915.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 17100.3
            },
            {
              "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": 17703.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12915.76
            },
            {
              "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": 3621.24
            },
            {
              "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": 16496.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16496.76
            },
            {
              "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": 14686.14
            },
            {
              "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": 20118,
              "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": 17100.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12714.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 4405.84
            },
            {
              "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": 12915.76
            },
            {
              "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": 20118,
              "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": 14686.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 17100.3
            },
            {
              "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": 20118,
              "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": 13096.82
            },
            {
              "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": 16275.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16496.76
            },
            {
              "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": 20118,
              "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": 17100.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 16496.76
            },
            {
              "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": 20118,
              "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": 16677.82
            },
            {
              "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": 12714.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 20118,
              "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": 13096.82
            },
            {
              "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": 20118,
              "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": 16275.46
            },
            {
              "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": 17643.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11064.9
            },
            {
              "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": 20118,
              "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": 12714.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12714.58
            },
            {
              "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": 17100.3
            },
            {
              "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": 20118,
              "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": 16496.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16496.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11064.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17100.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12915.76
            },
            {
              "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": 12915.76
            },
            {
              "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": 13096.82
            },
            {
              "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": 20118,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17100.3
            },
            {
              "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": 20118,
              "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": 20118,
              "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": 13096.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 13096.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14686.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12714.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12714.58
            },
            {
              "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": 20118,
              "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": 16677.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16496.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 20118,
              "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": 17100.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14686.14
            },
            {
              "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": 20118,
              "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": 16677.82
            },
            {
              "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": 20118,
              "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": 12915.76
            },
            {
              "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": 12714.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17100.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15088.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11064.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17100.3
            },
            {
              "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": 12714.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12915.76
            },
            {
              "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": 5492.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 20118,
              "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": 17100.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17100.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17100.3
            },
            {
              "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": 17643.49
            },
            {
              "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": 11064.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14686.14
            },
            {
              "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": 20118,
              "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": 14686.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 13076.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12915.76
            },
            {
              "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": 16496.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12915.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15088.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11064.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17100.3
            },
            {
              "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": 12915.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 20118,
              "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": 20118,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3621.24
            },
            {
              "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": 12915.76
            },
            {
              "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": 20118,
              "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": 20118,
              "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": 20118,
              "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": 11064.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11064.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15088.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20118,
              "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": 12915.76
            },
            {
              "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": 20118,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Rem and Replace Pacer Pulse Gen Mult",
      "code_information": [
        {
          "code": "PX-36100191",
          "type": "CDM"
        },
        {
          "code": "33229",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18676,
          "discounted_cash": 12139.4,
          "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": 11989.99
            },
            {
              "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": 11989.99
            },
            {
              "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": 11803.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15874.6
            },
            {
              "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": 11989.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11989.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10271.8
            },
            {
              "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": 13633.48
            },
            {
              "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": 15108.88
            },
            {
              "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": 15314.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15314.32
            },
            {
              "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": 17006.41,
              "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": 15482.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 18676
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15482.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10271.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 17856.73,
              "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": 11989.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11989.99
            },
            {
              "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": 11989.99
            },
            {
              "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": 15874.6
            },
            {
              "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": 17176.47,
              "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": 14007
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13633.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11803.23
            },
            {
              "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": 17006.41,
              "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": 18676,
              "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": 18676,
              "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": 18676,
              "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": 10271.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11989.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15314.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11803.23
            },
            {
              "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": 16378.85
            },
            {
              "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": 17353.48,
              "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": 15874.6
            },
            {
              "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": 18676,
              "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": 13633.48
            },
            {
              "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": 15874.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15874.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 18676
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10271.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10271.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15482.4
            },
            {
              "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": 18676,
              "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": 15874.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 12158.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12158.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13633.48
            },
            {
              "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": 17856.73,
              "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": 12139.4
            },
            {
              "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": 16434.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15874.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14007
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 18676,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 4090.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 18676
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14007
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10271.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 18676
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11803.23
            },
            {
              "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": 18676,
              "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": 15874.6
            },
            {
              "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": 12158.08
            },
            {
              "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": 15314.32
            },
            {
              "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": 18676,
              "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": 11803.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 17353.48,
              "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": 11803.23
            },
            {
              "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": 5098.55
            },
            {
              "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": 16378.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12158.08
            },
            {
              "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": 15314.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15108.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 18676,
              "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": 17353.48,
              "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": 3361.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15874.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 18676
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10271.8
            },
            {
              "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": 17176.47,
              "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": 17176.47,
              "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": 15874.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11989.99
            },
            {
              "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": 11803.23
            },
            {
              "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": 17006.41,
              "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": 11989.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15314.32
            },
            {
              "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": 12158.08
            },
            {
              "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": 17176.47,
              "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": 17856.73,
              "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": 18676,
              "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": 18676,
              "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": 15874.6
            },
            {
              "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": 17176.47,
              "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": 15874.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 15874.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3361.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13633.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 17006.41,
              "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": 11803.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18676,
              "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": 11989.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15314.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11989.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15314.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13633.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15874.6
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Icd Generator Only Dual",
      "code_information": [
        {
          "code": "PX-36100192",
          "type": "CDM"
        },
        {
          "code": "33230",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23817,
          "discounted_cash": 15481.05,
          "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": 15290.51
            },
            {
              "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": 19744.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15290.51
            },
            {
              "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": 20244.45
            },
            {
              "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": 23817,
              "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": 17386.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 23817,
              "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": 23817,
              "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": 23817,
              "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": 20244.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 23817,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19267.95
            },
            {
              "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": 15052.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "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": 15052.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17386.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15504.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 23817,
              "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": 17386.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 23817,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15052.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 15290.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19529.94
            },
            {
              "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": 19529.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15052.34
            },
            {
              "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": 15504.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15052.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 23817,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17386.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15290.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17862.75
            },
            {
              "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": 6502.04
            },
            {
              "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": 15052.34
            },
            {
              "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": 15290.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 13099.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 15481.05
            },
            {
              "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": 15290.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17862.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15504.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19529.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19529.94
            },
            {
              "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": 19529.94
            },
            {
              "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": 15290.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19529.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13099.35
            },
            {
              "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": 23817,
              "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": 15052.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13099.35
            },
            {
              "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": 17386.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19744.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15290.51
            },
            {
              "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": 15504.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 20244.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15290.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15504.87
            },
            {
              "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": 20887.51
            },
            {
              "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": 19267.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13099.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13099.35
            },
            {
              "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": 23817,
              "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": 15290.51
            },
            {
              "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": 15290.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20244.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 13099.35
            },
            {
              "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": 20244.45
            },
            {
              "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": 20958.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15052.34
            },
            {
              "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": 23817,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15290.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19529.94
            },
            {
              "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": 20887.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23817,
              "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": 23817,
              "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": 13099.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17386.41
            },
            {
              "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": 19529.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19744.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17862.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insertion Icd Generator Only Single",
      "code_information": [
        {
          "code": "PX-36100197",
          "type": "CDM"
        },
        {
          "code": "33240",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 26020,
          "discounted_cash": 16913,
          "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": 16704.84
            },
            {
              "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": 21050.18
            },
            {
              "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": 22819.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 26020,
              "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": 26020,
              "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": 21570.58
            },
            {
              "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": 21336.4
            },
            {
              "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": 16704.84
            },
            {
              "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": 16704.84
            },
            {
              "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": 21336.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16444.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21336.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16704.84
            },
            {
              "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": 16939.02
            },
            {
              "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": 26020,
              "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": 21570.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14311
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16444.64
            },
            {
              "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": 16444.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 16704.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19515
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18994.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16939.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 26020,
              "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": 22117
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18994.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16939.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14311
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16444.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16444.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 16704.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21336.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 18994.6
            },
            {
              "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": 16939.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 22117
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 26020,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 21336.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18994.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16704.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16444.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16939.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16704.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16704.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 26020,
              "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": 26020,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16444.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 16704.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21336.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14311
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18994.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14311
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 26020,
              "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": 16704.84
            },
            {
              "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": 7103.46
            },
            {
              "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": 22819.54
            },
            {
              "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": 22897.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22117
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 26020,
              "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": 26020,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21570.58
            },
            {
              "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": 21336.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14311
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 26020,
              "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": 16913
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14311
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 21050.18
            },
            {
              "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": 26020,
              "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": 16444.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 26020,
              "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": 18994.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16704.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21336.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19515
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19515
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14311
            }
          ]
        }
      ]
    },
    {
      "description": "HC Remove Replace Icd Gen Mult Lead Sys",
      "code_information": [
        {
          "code": "PX-36100203",
          "type": "CDM"
        },
        {
          "code": "33264",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21260,
          "discounted_cash": 13819,
          "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": 13648.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17433.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18071
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13436.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17433.2
            },
            {
              "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": 18071
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13436.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 18071
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 30149.54,
              "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": 13436.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13436.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 18071
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18071
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11693
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18071
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11693
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28713.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 21260
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 13819
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13840.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17433.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18071
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3826.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 18708.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15519.8
            },
            {
              "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": 29000.98,
              "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": 13436.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 17433.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15519.8
            },
            {
              "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": 13436.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 15519.8
            },
            {
              "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": 29000.98,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 21260
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17624.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 21260,
              "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": 15519.8
            },
            {
              "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": 13648.92
            },
            {
              "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": 28713.84,
              "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": 13648.92
            },
            {
              "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": 5803.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18071
            },
            {
              "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": 3826.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 11693
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29000.98,
              "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": 21260,
              "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": 28680.54,
              "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": 15945
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17433.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 21260
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28680.54,
              "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": 18071
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17433.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 18071
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13648.92
            },
            {
              "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": 28713.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 21260
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11693
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 18645.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13648.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13648.92
            },
            {
              "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": 17433.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11693
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 30149.54,
              "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": 18071
            },
            {
              "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": 4655.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 17199.34
            },
            {
              "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": 17624.54
            },
            {
              "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": 21260,
              "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": 21260,
              "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": 18071
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 21260,
              "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": 13648.92
            },
            {
              "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": 13648.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13648.92
            },
            {
              "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": 17199.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18071
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15945
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15519.8
            },
            {
              "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": 15519.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15945
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13840.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17624.54
            },
            {
              "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": 21260,
              "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": 29000.98,
              "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": 13648.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13840.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17433.2
            },
            {
              "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": 13648.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28713.84,
              "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": 11693
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13436.32
            },
            {
              "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": 18645.02
            },
            {
              "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": 28680.54,
              "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": 18071
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13840.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "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": 13436.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21260,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 21260
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11693
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29000.98,
              "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": 13840.26
            },
            {
              "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": 30149.54,
              "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": 13648.92
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sel Cath Placement Seg or Subseg Pulm Artery",
      "code_information": [
        {
          "code": "PX-36100252",
          "type": "CDM"
        },
        {
          "code": "36015",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1399,
          "discounted_cash": 909.35,
          "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": 898.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 898.16
            },
            {
              "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": 1189.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 898.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 910.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 884.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 884.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 898.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1147.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1049.25
            },
            {
              "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": 898.16
            },
            {
              "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": 910.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1021.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1049.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 769.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 1399,
              "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": 1399,
              "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": 1399,
              "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": 1189.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 898.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 910.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 884.17
            },
            {
              "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": 1399,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1399,
              "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": 769.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1021.27
            },
            {
              "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": 1147.18
            },
            {
              "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": 1159.77
            },
            {
              "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": 1189.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 884.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 884.17
            },
            {
              "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": 1231.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1147.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 898.16
            },
            {
              "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": 1226.92
            },
            {
              "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": 909.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1021.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1021.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1159.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 898.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 769.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1159.77
            },
            {
              "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": 884.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "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": 1021.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 1399,
              "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": 898.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1147.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "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": 1131.79
            },
            {
              "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": 1226.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 1399,
              "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": 769.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 769.45
            },
            {
              "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": 884.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 1399,
              "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": 1189.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "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": 898.16
            },
            {
              "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": 898.16
            },
            {
              "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": 898.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1131.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 884.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1021.27
            },
            {
              "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": 1399,
              "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": 910.75
            },
            {
              "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": 381.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "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": 1147.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1147.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 1399,
              "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": 1399,
              "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": 1399,
              "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": 769.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1147.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1189.15
            },
            {
              "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": 910.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 769.45
            },
            {
              "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": 1147.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1399,
              "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": 1399,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1049.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Picc WO Sq Port WO Imaging Guidance Age 5 or Older",
      "code_information": [
        {
          "code": "PX-36100299",
          "type": "CDM"
        },
        {
          "code": "36569",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3389,
          "discounted_cash": 2202.85,
          "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": 2175.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2778.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 3389,
              "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": 3389,
              "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": 2141.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2175.74
            },
            {
              "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": 2778.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1863.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2541.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 2880.65
            },
            {
              "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": 1426.32,
              "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": 1467.69,
              "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": 3389,
              "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": 1426.32,
              "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": 2880.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2880.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 1411.77,
              "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": 1411.77,
              "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": 2175.74
            },
            {
              "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": 1397.8,
              "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": 2175.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2175.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2206.24
            },
            {
              "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": 2141.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 2880.65
            },
            {
              "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": 2141.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1863.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2778.98
            },
            {
              "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": 1411.77,
              "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": 2880.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3389
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2141.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 3389,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3389
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2778.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1863.95
            },
            {
              "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": 2141.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1863.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 2541.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2141.85
            },
            {
              "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": 3389,
              "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": 2202.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2473.97
            },
            {
              "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": 2175.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 3389
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 2175.74
            },
            {
              "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": 2175.74
            },
            {
              "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": 2741.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2141.85
            },
            {
              "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": 2972.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 2880.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2473.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 3389,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 3389
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1411.77,
              "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": 2175.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2175.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2741.7
            },
            {
              "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": 3389,
              "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": 3389,
              "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": 2982.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2880.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2809.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2175.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2541.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2206.24
            },
            {
              "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": 2972.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2141.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2778.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2880.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1863.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2473.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2880.65
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 423
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2880.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3389,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2778.98
            },
            {
              "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": 2473.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3389
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3389,
              "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": 1426.32,
              "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": 2880.65
            },
            {
              "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": 1397.8,
              "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": 1863.95
            },
            {
              "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": 1411.77,
              "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": 2175.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2778.98
            },
            {
              "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": 2206.24
            },
            {
              "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": 925.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2473.97
            },
            {
              "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": 2880.65
            },
            {
              "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": 1467.69,
              "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": 3389,
              "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": 1863.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1467.69,
              "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": 1397.8,
              "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": 1397.8,
              "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": 2206.24
            },
            {
              "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": 2809.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2809.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2473.97
            },
            {
              "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": 3389,
              "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": 3389,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2778.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2880.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2880.65
            },
            {
              "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": 2206.24
            }
          ]
        }
      ]
    },
    {
      "description": "HC Declot Cath or Vad by Thrombolytic",
      "code_information": [
        {
          "code": "PX-36100311",
          "type": "CDM"
        },
        {
          "code": "36593",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2933,
          "discounted_cash": 1906.45,
          "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": 1882.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2431.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2431.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2141.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2933
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1853.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2933
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2431.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2405.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1882.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2405.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "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": 2493.05
            },
            {
              "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": 298.54,
              "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": 2493.05
            },
            {
              "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": 295.58,
              "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": 2493.05
            },
            {
              "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": 1909.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1853.66
            },
            {
              "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": 295.58,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2933
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1853.66
            },
            {
              "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": 1853.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "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": 1906.45
            },
            {
              "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": 2581.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "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": 2493.05
            },
            {
              "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": 298.54,
              "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": 1882.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1882.99
            },
            {
              "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": 2933,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2493.05
            },
            {
              "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": 298.54,
              "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": 1882.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1882.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1853.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 301.62,
              "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": 2405.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2372.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2405.06
            },
            {
              "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": 2933,
              "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": 1853.66
            },
            {
              "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": 1882.99
            },
            {
              "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": 1882.99
            },
            {
              "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": 1909.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2493.05
            },
            {
              "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": 2933,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2493.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1613.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2141.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1882.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2405.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2199.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "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": 2933,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1613.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "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": 2493.05
            },
            {
              "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": 295.58,
              "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": 2933,
              "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": 2933,
              "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": 2493.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "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": 1613.15
            },
            {
              "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": 1613.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1613.15
            },
            {
              "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": 298.54,
              "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": 2933,
              "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": 2933,
              "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": 1882.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1909.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1853.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2493.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1613.15
            },
            {
              "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": 2933,
              "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": 1909.38
            },
            {
              "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": 2572.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2933
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1613.15
            },
            {
              "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": 310.36,
              "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": 2933,
              "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": 310.36,
              "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": 2933,
              "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": 2933,
              "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": 2493.05
            },
            {
              "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": 310.36,
              "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": 2141.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2141.09
            },
            {
              "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": 295.58,
              "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": 1853.66
            },
            {
              "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": 2933,
              "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": 2199.75
            },
            {
              "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": 2141.09
            },
            {
              "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": 1882.99
            },
            {
              "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": 2405.06
            },
            {
              "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": 800.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2933,
              "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": 2141.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2493.05
            },
            {
              "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": 301.62,
              "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": 298.54,
              "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": 2572.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2933
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2199.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1909.38
            },
            {
              "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": 2405.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1882.99
            },
            {
              "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": 2372.8
            },
            {
              "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": 2405.06
            },
            {
              "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": 301.62,
              "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": 2493.05
            },
            {
              "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": 2493.05
            }
          ]
        }
      ]
    },
    {
      "description": "HC Thrombolysis Cerebral IV Infusion",
      "code_information": [
        {
          "code": "PX-36100336",
          "type": "CDM"
        },
        {
          "code": "37195",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 575,
          "discounted_cash": 373.75,
          "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": 369.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 488.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 316.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 369.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 419.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 419.75
            },
            {
              "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": 471.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 316.25
            },
            {
              "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": 373.75
            },
            {
              "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": 506
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 363.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 374.33
            },
            {
              "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": 374.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 575,
              "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": 575,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 363.4
            },
            {
              "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": 504.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 419.75
            },
            {
              "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": 419.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 369.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 471.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 369.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 431.25
            },
            {
              "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": 465.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 316.25
            },
            {
              "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": 488.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 363.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 504.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 431.25
            },
            {
              "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": 369.15
            },
            {
              "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": 471.5
            },
            {
              "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": 156.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 363.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 471.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 471.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 575,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 363.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 369.15
            },
            {
              "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": 363.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 488.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 363.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 476.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "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": 575,
              "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": 476.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 431.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 476.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 316.25
            },
            {
              "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": 316.25
            },
            {
              "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": 575,
              "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": 471.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 316.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 419.75
            },
            {
              "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": 363.4
            },
            {
              "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": 488.75
            },
            {
              "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": 369.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 471.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 471.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 374.33
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 488.75
            },
            {
              "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": 369.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 369.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 465.18
            },
            {
              "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": 374.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 316.25
            },
            {
              "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": 575,
              "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": 369.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 369.15
            },
            {
              "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": 369.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 374.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "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": 575,
              "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": 575,
              "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": 575,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 575,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 419.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Trnscth Tx Thrmb Cessation",
      "code_information": [
        {
          "code": "PX-36100349",
          "type": "CDM"
        },
        {
          "code": "37214",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37704,
          "discounted_cash": 24507.6,
          "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": 24205.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24205.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 20737.2
            },
            {
              "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": 20737.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31256.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30917.28
            },
            {
              "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": 2781.99,
              "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": 32048.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "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": 24545.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30502.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 37704,
              "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": 2838.77,
              "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": 20737.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27523.92
            },
            {
              "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": 2809.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31256.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24205.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30917.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23828.93
            },
            {
              "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": 37704,
              "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": 24507.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30917.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28278
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2921.09,
              "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": 37704,
              "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": 2921.09,
              "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": 23828.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 27523.92
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 6786.72
            },
            {
              "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": 23828.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23828.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 37704,
              "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": 24205.97
            },
            {
              "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": 30917.28
            },
            {
              "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": 2781.99,
              "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": 23828.93
            },
            {
              "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": 24545.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24545.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30917.28
            },
            {
              "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": 2809.81,
              "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": 24205.97
            },
            {
              "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": 30917.28
            },
            {
              "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": 6786.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28278
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33066.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 37704,
              "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": 23828.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 33179.52
            },
            {
              "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": 2781.99,
              "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": 2838.77,
              "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": 37704,
              "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": 32048.4
            },
            {
              "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": 2921.09,
              "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": 24205.97
            },
            {
              "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": 30917.28
            },
            {
              "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": 10293.19
            },
            {
              "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": 2838.77,
              "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": 24205.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24205.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20737.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23828.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24545.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 8873
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27523.92
            },
            {
              "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": 2809.81,
              "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": 32048.4
            },
            {
              "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": 33066.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 37704,
              "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": 37704,
              "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": 20737.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27523.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24205.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24545.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20737.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 37704,
              "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": 27523.92
            },
            {
              "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": 2809.81,
              "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": 32048.4
            },
            {
              "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": 24205.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 23828.93
            },
            {
              "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": 8257.18
            },
            {
              "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": 2809.81,
              "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": 30502.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28278
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20737.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27523.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24205.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24205.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31256.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37704,
              "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": 2781.99,
              "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": 32048.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30917.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32048.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tibiopero W Stnt&Atherec Ea Addl",
      "code_information": [
        {
          "code": "PX-36100367",
          "type": "CDM"
        },
        {
          "code": "37235",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5068,
          "discounted_cash": 3294.2,
          "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": 3253.66
            },
            {
              "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": 3299.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "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": 3202.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "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": 4307.8
            },
            {
              "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": 3202.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3801
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "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": 5068,
              "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": 3299.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3801
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "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": 2787.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 5068,
              "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": 2787.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3294.2
            },
            {
              "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": 4459.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "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": 3202.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "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": 4155.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3253.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "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": 1383.56
            },
            {
              "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": 3253.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3299.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "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": 4155.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4201.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "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": 4100.01
            },
            {
              "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": 4155.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3253.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5068,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3253.66
            },
            {
              "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": 5068,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5068,
              "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": 3253.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3299.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "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": 5068,
              "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": 3299.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "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": 4444.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3253.66
            },
            {
              "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": 3253.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4100.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4201.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3699.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "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": 4307.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3801
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "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": 4444.64
            },
            {
              "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": 3699.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3253.66
            },
            {
              "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": 4201.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 5068,
              "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": 5068,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Inj Cystography or Voiding Urethrocysto",
      "code_information": [
        {
          "code": "PX-36100464",
          "type": "CDM"
        },
        {
          "code": "51600",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3320,
          "discounted_cash": 2158,
          "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": 2131.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1826
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2921.6
            },
            {
              "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": 2752.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 3320,
              "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": 3320,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2752.28
            },
            {
              "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": 2131.44
            },
            {
              "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": 2161.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3320,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 2822
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3320,
              "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": 2722.4
            },
            {
              "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": 3320,
              "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": 2098.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 1826
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2423.6
            },
            {
              "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": 3320,
              "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": 3320,
              "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": 2722.4
            },
            {
              "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": 2911.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 2098.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 1826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2131.44
            },
            {
              "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": 2131.44
            },
            {
              "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": 2161.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2161.32
            },
            {
              "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": 3320,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2098.24
            },
            {
              "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": 3320,
              "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": 3320,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 2158
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2131.44
            },
            {
              "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": 906.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1826
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 2098.24
            },
            {
              "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": 2423.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 2423.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2423.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3320,
              "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": 2685.88
            },
            {
              "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": 3320,
              "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": 3320,
              "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": 3320,
              "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": 3320,
              "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": 2722.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2131.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2752.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2098.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 3320,
              "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": 1826
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 2822
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 3320,
              "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": 2490
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1826
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2131.44
            },
            {
              "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": 2822
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3320,
              "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": 3320,
              "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": 2423.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2131.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2098.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2098.24
            },
            {
              "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": 3320,
              "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": 2131.44
            },
            {
              "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": 2911.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2098.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 2822
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2490
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2161.32
            },
            {
              "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": 2722.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2685.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2490
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2722.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2161.32
            },
            {
              "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": 2722.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2423.6
            },
            {
              "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": 3320,
              "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": 3320,
              "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": 2822
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 423
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2131.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2722.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "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": 3320,
              "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": 2131.44
            },
            {
              "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": 2131.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3320,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2822
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2722.4
            },
            {
              "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": 3320,
              "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": 3320,
              "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": 3320,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Inj Corpora Cavernosography",
      "code_information": [
        {
          "code": "PX-36100482",
          "type": "CDM"
        },
        {
          "code": "54230",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3500,
          "discounted_cash": 2275,
          "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": 2247
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3069.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2212
            },
            {
              "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": 3500,
              "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": 3500,
              "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": 3500,
              "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": 2901.5
            },
            {
              "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": 2555
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2212
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2212
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 2975
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3080
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2247
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2278.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 3500,
              "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": 3500,
              "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": 2975
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2212
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 1925
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2625
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2247
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2212
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2555
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2870
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3500,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1925
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2555
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2870
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2247
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2278.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2870
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2555
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2212
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 2625
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2275
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 3500,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2870
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2831.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2901.5
            },
            {
              "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": 2870
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2831.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 2975
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1925
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3069.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1925
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3500,
              "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": 2212
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3500,
              "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": 2901.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2247
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1925
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3500,
              "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": 2247
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2278.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2870
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 3500,
              "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": 2247
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2247
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 3500,
              "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": 2975
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2870
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2555
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1925
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2555
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3500,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "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": 2247
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2278.5
            },
            {
              "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": 2247
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2278.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2625
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2247
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 955.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2212
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3500,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1925
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2870
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2975
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2247
            }
          ]
        }
      ]
    },
    {
      "description": "HC Unlisted Fem Genital Procedure",
      "code_information": [
        {
          "code": "PX-36100493",
          "type": "CDM"
        },
        {
          "code": "58999",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1903,
          "discounted_cash": 1236.95,
          "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": 1221.73
            },
            {
              "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": 1221.73
            },
            {
              "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": 1560.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1202.7
            },
            {
              "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": 1202.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1903,
              "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": 1221.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1238.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 173.92,
              "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": 175.66,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 1903
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1236.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1046.65
            },
            {
              "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": 1238.85
            },
            {
              "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": 177.47,
              "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": 1046.65
            },
            {
              "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": 182.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 1903
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1903,
              "additional_payer_notes": "ASC UNLISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1427.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1577.59
            },
            {
              "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": 1560.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1903,
              "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": 1046.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1046.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1560.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "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": 1560.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1903,
              "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": 1617.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1389.19
            },
            {
              "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": 1202.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1903,
              "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": 1617.55
            },
            {
              "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": 1221.73
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 173.92,
              "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": 1202.7
            },
            {
              "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": 175.66,
              "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": 1903,
              "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": 1427.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1539.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1389.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1238.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1560.46
            },
            {
              "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": 1046.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1389.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 26.3,
              "estimated_amount": 500.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1221.73
            },
            {
              "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": 1539.53
            },
            {
              "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": 175.66,
              "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": 1617.55
            },
            {
              "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": 1903,
              "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": 1238.85
            },
            {
              "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": 519.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1202.7
            },
            {
              "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": 177.47,
              "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": 1389.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1560.46
            },
            {
              "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": 1668.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 175.66,
              "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": 1202.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1202.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1221.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1221.73
            },
            {
              "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": 1668.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 1903
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1577.59
            },
            {
              "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": 1221.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1221.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1238.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1560.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1389.19
            },
            {
              "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": 175.66,
              "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": 1903,
              "additional_payer_notes": "ASC UNLISTED"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1577.59
            },
            {
              "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": 182.61,
              "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": 1427.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 1903
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1617.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1903,
              "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": 1046.65
            },
            {
              "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": 1389.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1617.55
            },
            {
              "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": 173.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 1903
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 182.61,
              "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": 1560.46
            },
            {
              "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": 177.47,
              "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": 1903,
              "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": 1674.64
            },
            {
              "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": 173.92,
              "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": 1046.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1221.73
            },
            {
              "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": 1221.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1202.7
            },
            {
              "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": 1903,
              "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": 1221.73
            }
          ]
        }
      ]
    },
    {
      "description": "Amniocentesis Therapeutic W US Guidance",
      "code_information": [
        {
          "code": "PX-36100495",
          "type": "CDM"
        },
        {
          "code": "59001",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2701,
          "discounted_cash": 1755.65,
          "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": 1734.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 293.99,
              "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": 1707.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2295.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2025.75
            },
            {
              "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": 279.99,
              "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": 1971.73
            },
            {
              "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": 282.79,
              "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": 1734.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1758.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2025.75
            },
            {
              "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": 279.99,
              "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": 285.71,
              "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": 1485.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 285.71,
              "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": 2295.85
            },
            {
              "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": 2214.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1707.03
            },
            {
              "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": 279.99,
              "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": 2701,
              "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": 1734.04
            },
            {
              "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": 282.79,
              "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": 2025.75
            },
            {
              "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": 1707.03
            },
            {
              "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": 1707.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2295.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1734.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2185.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2701
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2239.13
            },
            {
              "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": 2239.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1734.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2295.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 1971.73
            },
            {
              "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": 2701,
              "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": 2368.78
            },
            {
              "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": 282.79,
              "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": 2295.85
            },
            {
              "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": 2214.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2214.82
            },
            {
              "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": 737.37
            },
            {
              "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": 2295.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 2701,
              "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": 2701,
              "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": 1734.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2214.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1707.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 1485.55
            },
            {
              "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": 1971.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 2376.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1485.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2701
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1707.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2295.85
            },
            {
              "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": 1734.04
            },
            {
              "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": 1734.04
            },
            {
              "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": 1758.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1707.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1758.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1758.35
            },
            {
              "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": 2214.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1485.55
            },
            {
              "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": 282.79,
              "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": 2295.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 2295.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 2701,
              "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": 1485.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1485.55
            },
            {
              "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": 285.71,
              "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": 2295.85
            },
            {
              "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": 2701,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 1734.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1971.73
            },
            {
              "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": 282.79,
              "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": 2701,
              "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": 1755.65
            },
            {
              "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": 279.99,
              "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": 2701,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2214.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2701
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 2701,
              "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": 2295.85
            },
            {
              "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": 293.99,
              "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": 2214.82
            },
            {
              "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": 1734.04
            },
            {
              "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": 293.99,
              "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": 1485.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2295.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2295.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1971.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2701
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2239.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2701,
              "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": 2701,
              "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": 1758.35
            },
            {
              "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": 2185.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2214.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1734.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1734.04
            },
            {
              "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": 2368.78
            },
            {
              "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": 1707.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2701
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1971.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2295.85
            },
            {
              "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": 2701,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Endovasc Temp Balloon Arterial Occlus Head or Neck",
      "code_information": [
        {
          "code": "PX-36100506",
          "type": "CDM"
        },
        {
          "code": "61623",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12348,
          "discounted_cash": 8026.2,
          "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": 7927.42
            },
            {
              "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": 6791.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 12348,
              "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": 10495.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 12348,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7927.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7803.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "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": 10125.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6791.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "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": 7803.94
            },
            {
              "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": 8026.2
            },
            {
              "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": 7803.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6791.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9014.04
            },
            {
              "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": 7927.42
            },
            {
              "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": 8038.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9989.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7803.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 12348,
              "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": 10495.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12348,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9261
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "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": 7803.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9014.04
            },
            {
              "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": 10866.24
            },
            {
              "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": 9014.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7927.42
            },
            {
              "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": 8038.55
            },
            {
              "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": 10125.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10236.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 7927.42
            },
            {
              "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": 10829.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6791.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9014.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 12348,
              "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": 10236.49
            },
            {
              "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": 7927.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8038.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8038.55
            },
            {
              "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": 9989.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10125.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 12348,
              "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": 10125.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6791.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10125.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 10495.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12348,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 12348,
              "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": 10495.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9014.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7927.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7803.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 6791.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9261
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 7927.42
            },
            {
              "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": 7927.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10125.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9261
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12348,
              "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": 12348,
              "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": 12348,
              "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": 7927.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7927.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8038.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10236.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7803.94
            },
            {
              "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": 12348,
              "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": 10125.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9014.04
            },
            {
              "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": 12348,
              "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": 7803.94
            },
            {
              "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": 10829.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10125.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6791.4
            },
            {
              "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": 3371
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10495.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7927.42
            }
          ]
        }
      ]
    },
    {
      "description": "HC Perc Implant Neurostim Electrode Array",
      "code_information": [
        {
          "code": "PX-36100537",
          "type": "CDM"
        },
        {
          "code": "63650",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 24800,
          "discounted_cash": 16120,
          "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": 15921.6
            },
            {
              "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": 15921.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15921.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13640
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18104
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 24800
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18600
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15921.6
            },
            {
              "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": 15921.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20336
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15921.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16144.8
            },
            {
              "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": 24800,
              "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": 15673.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20336
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6770.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13640
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20336
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 24800,
              "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": 24800,
              "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": 13640
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13640
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6028.8,
              "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": 20559.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18104
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15921.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6028.8,
              "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": 6028.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15921.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 21080
            },
            {
              "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": 4464
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18104
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 21824
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6267.56,
              "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": 16144.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15673.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15673.6
            },
            {
              "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": 15921.6
            },
            {
              "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": 16144.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20063.2
            },
            {
              "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": 20336
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20336
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5969.1,
              "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": 6267.56,
              "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": 18104
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 21749.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20336
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15673.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 18104
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6028.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 24800
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15673.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 18600
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 4464
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 24800,
              "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": 24800,
              "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": 15921.6
            },
            {
              "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": 20559.2
            },
            {
              "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": 6267.56,
              "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": 24800,
              "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": 24800,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 5431.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13640
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20336
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5969.1,
              "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": 13640
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 24800
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15673.6
            },
            {
              "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": 6090.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 24800
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20559.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 16144.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16144.8
            },
            {
              "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": 21749.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 13640
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18600
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15673.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 21080
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18104
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15921.6
            },
            {
              "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": 5969.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 24800
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 6090.92,
              "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": 24800,
              "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": 20336
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 21080
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21080
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15673.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24800,
              "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": 16120
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6090.92,
              "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": 6028.8,
              "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": 15921.6
            },
            {
              "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": 20063.2
            },
            {
              "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": 5969.1,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC or Level 1 Ep Addl 15 Min",
      "code_information": [
        {
          "code": "PX-36100601",
          "type": "CDM"
        },
        {
          "code": "36100601",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1098,
          "discounted_cash": 713.7,
          "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": 704.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 603.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 693.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 603.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1098,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1098,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "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": 900.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 801.54
            },
            {
              "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": 704.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "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": 1098,
              "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": 603.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 603.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 900.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 910.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "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": 801.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 704.92
            },
            {
              "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": 693.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 693.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1098,
              "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": 689.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 712.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 714.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 714.8
            },
            {
              "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": 900.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 823.5
            },
            {
              "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": 714.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 900.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 693.94
            },
            {
              "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": 704.92
            },
            {
              "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": 962.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 712.6
            },
            {
              "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": 1098,
              "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": 603.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 693.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "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": 933.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 603.9
            },
            {
              "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": 689.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "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": 966.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 900.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 900.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1098,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 704.92
            },
            {
              "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": 900.36
            },
            {
              "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": 689.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 714.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 801.54
            },
            {
              "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": 1098,
              "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": 933.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 704.92
            },
            {
              "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": 693.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1098,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1098,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 704.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 704.92
            },
            {
              "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": 962.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1098,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 910.24
            },
            {
              "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": 888.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 712.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 603.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 704.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 801.54
            },
            {
              "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": 933.3
            },
            {
              "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": 693.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 693.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 689.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 704.92
            },
            {
              "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": 714.8
            },
            {
              "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": 299.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 712.6
            },
            {
              "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": 713.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 801.54
            },
            {
              "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": 704.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 888.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 900.36
            },
            {
              "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": 910.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 933.3
            },
            {
              "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": 704.92
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sacroplasty Inj Bilat W Balloon or Device",
      "code_information": [
        {
          "code": "PX-36100609",
          "type": "CDM"
        },
        {
          "code": "0201T",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 38069,
          "discounted_cash": 24744.85,
          "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": 24440.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27790.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24059.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38069,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 30540
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38069,
              "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": 38069,
              "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": 38069,
              "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": 20937.95
            },
            {
              "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": 27790.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 30540
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27790.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38069,
              "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": 38069,
              "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": 38069,
              "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": 31216.58
            },
            {
              "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": 10392.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24782.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38069,
              "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": 6371.39,
              "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": 27790.37
            },
            {
              "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": 31559.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "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": 8337.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31559.2
            },
            {
              "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": 33386.51
            },
            {
              "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": 6556.16,
              "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": 24440.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24059.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20937.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20937.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24440.3
            },
            {
              "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": 32358.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 30540
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38069,
              "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": 6243.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 30540
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24440.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30797.82
            },
            {
              "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": 38069,
              "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": 38069,
              "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": 6371.39,
              "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": 6243.96,
              "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": 32358.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38069,
              "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": 38069,
              "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": 38069,
              "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": 33500.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20937.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28551.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24782.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24440.3
            },
            {
              "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": 24440.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24059.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24440.3
            },
            {
              "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": 30797.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31216.58
            },
            {
              "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": 24059.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "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": 24059.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38069,
              "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": 38069,
              "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": 38069,
              "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": 6371.39,
              "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": 6243.96,
              "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": 6306.4,
              "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": 28551.75
            },
            {
              "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": 24440.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31216.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28551.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24440.3
            },
            {
              "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": 31216.58
            },
            {
              "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": 31216.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38069,
              "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": 24440.3
            },
            {
              "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": 24782.92
            },
            {
              "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": 20937.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20937.95
            },
            {
              "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": 33386.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 30540
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24059.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20937.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24059.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31216.58
            },
            {
              "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": 6243.96,
              "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": 24440.3
            },
            {
              "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": 24782.92
            },
            {
              "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": 31216.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27790.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6556.16,
              "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": 38069,
              "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": 31216.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24440.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24059.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27790.37
            },
            {
              "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": 6556.16,
              "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": 24782.92
            },
            {
              "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": 38069,
              "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": 32358.65
            },
            {
              "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": 24744.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31559.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32358.65
            },
            {
              "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": 38069,
              "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": 38069,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Biopatch With Chg",
      "code_information": [
        {
          "code": "PX-CH-JJ3150",
          "type": "CDM"
        },
        {
          "code": "A6209",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.5,
          "discounted_cash": 10.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.59
            },
            {
              "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": 13.53
            },
            {
              "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": 16.5,
              "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": 63.2,
              "estimated_amount": 10.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 14.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.05
            },
            {
              "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": 10.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 16.5,
              "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": 12.05
            },
            {
              "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": 10.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 13.53
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.5,
              "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": 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": 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": 16.5,
              "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": 16.5,
              "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": 14.03
            },
            {
              "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": 16.5,
              "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": 10.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 16.5,
              "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": 13.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.38
            },
            {
              "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": 16.5,
              "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": 16.5,
              "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": 13.35
            },
            {
              "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": 10.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.03
            },
            {
              "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": 9.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 16.5,
              "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": 16.5,
              "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": 14.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.5,
              "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": 10.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.05
            },
            {
              "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": 16.5,
              "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": 16.5,
              "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": 9.16
            },
            {
              "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": 16.5,
              "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": 16.5,
              "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": 10.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.03
            },
            {
              "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": 16.5,
              "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": 14.03
            },
            {
              "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": 16.5,
              "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": 16.5,
              "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": 14.47
            },
            {
              "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": 10.59
            },
            {
              "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": 13.53
            },
            {
              "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": 9.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.5,
              "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": 4.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.08
            },
            {
              "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": 12.05
            },
            {
              "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": 10.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 9.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 16.5,
              "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": 10.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.53
            },
            {
              "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": 16.5,
              "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": 9.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.08
            },
            {
              "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": 16.5,
              "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": 14.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.74
            },
            {
              "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": 10.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.38
            },
            {
              "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": 10.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.38
            },
            {
              "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": 16.5,
              "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": 14.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 16.5,
              "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": 14.03
            },
            {
              "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": 14.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.68
            },
            {
              "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": 14.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.5,
              "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": 10.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.53
            },
            {
              "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": 16.5,
              "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": 16.5,
              "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": 16.5,
              "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": 13.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.03
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tca; 1- 2 So",
      "code_information": [
        {
          "code": "PX-30101267",
          "type": "CDM"
        },
        {
          "code": "80332",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41,
          "discounted_cash": 26.65,
          "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": 26.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 26.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 34.85
            },
            {
              "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": 41,
              "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": 34.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.91
            },
            {
              "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": 36.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.99
            },
            {
              "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": 22.76
            },
            {
              "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": 22.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.32
            },
            {
              "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": 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": 25.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 34.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.91
            },
            {
              "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": 26.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "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": 41,
              "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": 34.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "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": 29.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.32
            },
            {
              "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": 33.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.32
            },
            {
              "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": 26.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 29.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "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": 26.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "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": 26.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 22.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 26.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 41,
              "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": 26.32
            },
            {
              "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": 33.99
            },
            {
              "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": 33.62
            },
            {
              "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": 35.96
            },
            {
              "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": 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": 22.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "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": 34.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 41,
              "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": 33.62
            },
            {
              "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": 25.91
            },
            {
              "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": 25.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.85
            },
            {
              "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": 22.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 26.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.17
            },
            {
              "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": 33.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41,
              "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": 41,
              "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": 41,
              "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": 34.85
            },
            {
              "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": 41,
              "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": 41,
              "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": 34.85
            },
            {
              "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": 26.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.93
            },
            {
              "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": 41,
              "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": 41,
              "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": 30.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.99
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "HC Red Cells Leuko Reduced 1 Unit",
      "code_information": [
        {
          "code": "PX-39000007",
          "type": "CDM"
        },
        {
          "code": "P9016",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 982,
          "discounted_cash": 638.3,
          "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": 630.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 639.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 540.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 716.86
            },
            {
              "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": 834.7
            },
            {
              "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": 545.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 982,
              "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": 639.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 540.1
            },
            {
              "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": 175.4,
              "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": 620.62
            },
            {
              "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": 861.21
            },
            {
              "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": 982,
              "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": 982,
              "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": 545.01
            },
            {
              "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": 834.7
            },
            {
              "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": 620.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 805.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 716.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "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": 540.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 805.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 638.3
            },
            {
              "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": 864.16
            },
            {
              "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": 982,
              "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": 805.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 173.66,
              "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": 177.2,
              "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": 540.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 540.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "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": 175.4,
              "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": 630.44
            },
            {
              "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": 805.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 736.5
            },
            {
              "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": 175.4,
              "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": 620.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 639.28
            },
            {
              "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": 173.66,
              "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": 982
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 736.5
            },
            {
              "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": 182.34,
              "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": 630.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 805.24
            },
            {
              "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": 620.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 540.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 620.62
            },
            {
              "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": 173.66,
              "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": 834.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 639.28
            },
            {
              "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": 182.34,
              "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": 545.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 716.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "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": 630.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 982,
              "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": 630.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 639.28
            },
            {
              "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": 805.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 814.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 736.5
            },
            {
              "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": 716.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 716.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 175.4,
              "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": 630.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 794.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 982,
              "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": 268.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 982,
              "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": 630.44
            },
            {
              "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": 630.44
            },
            {
              "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": 794.44
            },
            {
              "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": 545.01
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 630.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 630.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 620.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 630.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 716.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 540.1
            },
            {
              "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": 982,
              "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": 620.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 177.2,
              "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": 175.4,
              "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": 182.34,
              "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": 630.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 982,
              "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": 177.2,
              "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": 173.66,
              "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": 982,
              "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": 861.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "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": 814.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 814.08
            },
            {
              "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": 982,
              "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": 834.7
            },
            {
              "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": 620.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 805.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 805.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 834.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 982,
              "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": 982,
              "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": 834.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC US Pregnant Uterus Transvaginal",
      "code_information": [
        {
          "code": "PX-40200020",
          "type": "CDM"
        },
        {
          "code": "76817",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 431,
          "discounted_cash": 280.15,
          "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": 276.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 276.7
            },
            {
              "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": 96.91,
              "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": 95.84,
              "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": 239.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 431,
              "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": 95.95,
              "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": 366.35
            },
            {
              "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": 100.75,
              "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": 96.91,
              "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": 431,
              "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": 357.3
            },
            {
              "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": 377.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 366.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 366.35
            },
            {
              "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": 272.39
            },
            {
              "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": 95.84,
              "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": 237.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.05
            },
            {
              "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": 100.75,
              "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": 431,
              "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": 314.63
            },
            {
              "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": 95.95,
              "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": 431,
              "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": 431,
              "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": 272.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 276.7
            },
            {
              "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": 348.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 353.42
            },
            {
              "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": 431,
              "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": 366.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 431,
              "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": 280.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 314.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 323.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 366.35
            },
            {
              "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": 377.99
            },
            {
              "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": 280.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 276.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 323.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 366.35
            },
            {
              "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": 357.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 431,
              "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": 431,
              "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": 280.58
            },
            {
              "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": 117.66
            },
            {
              "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": 314.63
            },
            {
              "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": 96.91,
              "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": 276.7
            },
            {
              "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": 100.75,
              "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": 239.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 314.63
            },
            {
              "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": 96.91,
              "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": 431,
              "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": 280.15
            },
            {
              "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": 366.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 96.91,
              "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": 239.21
            },
            {
              "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": 276.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 366.35
            },
            {
              "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": 353.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 348.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 272.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 272.39
            },
            {
              "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": 379.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 276.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 280.58
            },
            {
              "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": 280.58
            },
            {
              "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": 95.95,
              "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": 276.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 353.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 314.63
            },
            {
              "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": 272.39
            },
            {
              "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": 431,
              "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": 431,
              "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": 366.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 366.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 276.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 353.42
            },
            {
              "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": 431,
              "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": 272.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 272.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 353.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 323.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 353.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 431
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 357.3
            },
            {
              "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": 366.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 366.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 272.39
            },
            {
              "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": 239.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 276.7
            },
            {
              "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": 276.7
            },
            {
              "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": 95.95,
              "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": 366.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 237.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 314.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 366.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 95.84,
              "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": 353.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 353.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 431,
              "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": 431,
              "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": 237.05
            },
            {
              "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": 276.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC Application Short Leg Cast Walking",
      "code_information": [
        {
          "code": "PX-42000002",
          "type": "CDM"
        },
        {
          "code": "29425",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1267,
          "discounted_cash": 823.55,
          "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": 813.41
            },
            {
              "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": 345.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 696.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 813.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1076.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 924.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 813.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1267,
              "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": 824.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 950.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1267,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 813.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1076.95
            },
            {
              "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": 1111.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 800.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1038.94
            },
            {
              "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": 1038.94
            },
            {
              "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": 703.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1267
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1076.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 813.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 696.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 924.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1267,
              "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": 800.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 696.85
            },
            {
              "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": 813.41
            },
            {
              "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": 800.74
            },
            {
              "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": 1267,
              "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": 800.74
            },
            {
              "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": 1267,
              "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": 696.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1038.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1038.94
            },
            {
              "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": 696.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1267,
              "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": 813.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 813.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 950.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1076.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1025
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1111.16
            },
            {
              "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": 823.55
            },
            {
              "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": 1267,
              "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": 813.41
            },
            {
              "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": 800.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1267,
              "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": 1076.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 924.91
            },
            {
              "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": 703.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 696.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 924.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1076.95
            },
            {
              "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": 1076.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1076.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 824.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1076.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 924.91
            },
            {
              "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": 1076.95
            },
            {
              "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": 1050.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1025
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1038.94
            },
            {
              "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": 1038.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1050.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 800.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 800.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1076.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 813.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1038.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 824.82
            },
            {
              "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": 1038.94
            },
            {
              "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": 800.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1076.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 1267,
              "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": 703.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 824.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1050.34
            },
            {
              "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": 924.91
            },
            {
              "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": 1267,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 703.19
            },
            {
              "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": 813.41
            },
            {
              "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": 813.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1267,
              "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": 696.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 950.25
            },
            {
              "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": 824.82
            },
            {
              "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": 1114.96
            }
          ]
        }
      ]
    },
    {
      "description": "Pt Gait Training 15 Min",
      "code_information": [
        {
          "code": "PX-42000021",
          "type": "CDM"
        },
        {
          "code": "97116",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 189,
          "discounted_cash": 122.85,
          "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": 121.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.98
            },
            {
              "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": 189,
              "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": 121.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.97
            },
            {
              "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": 189,
              "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": 121.34
            },
            {
              "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": 119.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 123.04
            },
            {
              "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": 189,
              "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": 160.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 156.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 160.65
            },
            {
              "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": 121.34
            },
            {
              "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": 121.34
            },
            {
              "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": 121.34
            },
            {
              "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": 119.45
            },
            {
              "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": 104.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 28.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.95
            },
            {
              "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": 123.04
            },
            {
              "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": 189,
              "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": 189,
              "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": 28.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 189,
              "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": 189,
              "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": 121.34
            },
            {
              "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": 154.98
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 119.45
            },
            {
              "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": 154.98
            },
            {
              "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": 189,
              "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": 28.06
            },
            {
              "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": 189,
              "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": 160.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.34
            },
            {
              "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": 152.9
            },
            {
              "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": 28.06
            },
            {
              "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": 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": 154.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 160.65
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 123.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 119.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 189,
              "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": 122.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 160.65
            },
            {
              "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": 27.84
            },
            {
              "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": 103.95
            },
            {
              "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": 165.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 189,
              "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": 166.32
            },
            {
              "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": 51.6
            },
            {
              "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": 160.65
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 160.65
            },
            {
              "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": 104.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 189,
              "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": 121.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 156.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 141.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 141.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 119.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 103.95
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 119.45
            },
            {
              "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": 121.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 152.9
            },
            {
              "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": 104.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 119.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 160.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.97
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 123.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 160.65
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 156.68
            },
            {
              "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": 160.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.34
            },
            {
              "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": 29.46
            },
            {
              "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": 165.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 189,
              "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": 103.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 160.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 141.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 160.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 160.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 189
            },
            {
              "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": 28.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.98
            },
            {
              "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": 119.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 189,
              "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": 160.65
            },
            {
              "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": 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": 123.04
            },
            {
              "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": 154.98
            },
            {
              "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": 137.97
            }
          ]
        }
      ]
    },
    {
      "description": "Pt Performance Test 15 Min",
      "code_information": [
        {
          "code": "PX-42000034",
          "type": "CDM"
        },
        {
          "code": "97750",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 159,
          "discounted_cash": 103.35,
          "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": 102.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 159
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 102.08
            },
            {
              "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": 130.38
            },
            {
              "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": 32.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.49
            },
            {
              "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": 88.25
            },
            {
              "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": 103.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "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": 135.15
            },
            {
              "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": 102.08
            },
            {
              "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": 32.31
            },
            {
              "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": 159,
              "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": 87.45
            },
            {
              "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": 32.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 131.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "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": 102.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 159,
              "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": 159,
              "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": 159,
              "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": 88.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.07
            },
            {
              "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": 32.31
            },
            {
              "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": 32.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.49
            },
            {
              "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": 32.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.38
            },
            {
              "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": 32.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.07
            },
            {
              "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": 32.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 139.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.45
            },
            {
              "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": 130.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 159,
              "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": 159,
              "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": 119.25
            },
            {
              "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": 135.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.08
            },
            {
              "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": 100.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 135.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.08
            },
            {
              "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": 32.31
            },
            {
              "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": 116.07
            },
            {
              "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": 88.25
            },
            {
              "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": 100.49
            },
            {
              "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": 139.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 128.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.51
            },
            {
              "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": 130.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "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": 139.44
            },
            {
              "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": 100.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "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": 159,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.08
            },
            {
              "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": 159,
              "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": 135.15
            },
            {
              "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": 159,
              "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": 103.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 32.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.08
            },
            {
              "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": 43.41
            },
            {
              "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": 33.93
            },
            {
              "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": 131.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 159,
              "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": 116.07
            },
            {
              "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": 159,
              "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": 100.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 128.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 131.81
            },
            {
              "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": 32.31
            },
            {
              "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": 103.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            },
            {
              "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": 32.31
            },
            {
              "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": 103.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.45
            },
            {
              "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": 32.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.45
            },
            {
              "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": 32.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 88.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 159,
              "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": 159,
              "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": 159,
              "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": 102.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC Positional Nystagmus",
      "code_information": [
        {
          "code": "PX-92000008",
          "type": "CDM"
        },
        {
          "code": "92532",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 338,
          "discounted_cash": 219.7,
          "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": 217
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 219.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 213.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 280.2
            },
            {
              "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": 338,
              "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": 277.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 220.04
            },
            {
              "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": 338,
              "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": 213.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 220.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 220.04
            },
            {
              "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": 213.62
            },
            {
              "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": 287.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 287.3
            },
            {
              "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": 338,
              "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": 338,
              "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": 338,
              "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": 217
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 338,
              "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": 338,
              "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": 338,
              "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": 277.16
            },
            {
              "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": 296.43
            },
            {
              "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": 338,
              "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": 253.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "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": 338,
              "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": 338,
              "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": 338,
              "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": 338,
              "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": 338,
              "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": 246.74
            },
            {
              "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": 338,
              "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": 338,
              "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": 280.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 217
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 273.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 187.59
            },
            {
              "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": 187.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "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": 338,
              "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": 297.44
            },
            {
              "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": 338,
              "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": 338,
              "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": 287.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "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": 92.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 338,
              "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": 338,
              "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": 213.62
            },
            {
              "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": 338,
              "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": 217
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "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": 338,
              "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": 213.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 213.62
            },
            {
              "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": 338,
              "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": 287.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 280.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 253.5
            },
            {
              "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": 246.74
            },
            {
              "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": 217
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 296.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 220.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 277.16
            },
            {
              "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": 287.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 338
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 338,
              "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": 287.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 253.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 185.9
            },
            {
              "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": 338,
              "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": 338,
              "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": 187.59
            },
            {
              "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": 187.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "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": 220.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 213.62
            },
            {
              "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": 217
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 287.3
            },
            {
              "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": 338,
              "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": 287.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 213.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 246.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 217
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 338,
              "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": 338,
              "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": 273.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 338,
              "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": 287.3
            }
          ]
        }
      ]
    },
    {
      "description": "Shoe Covers Non Skid 1 Roll=10 Each",
      "code_information": [
        {
          "code": "PX-CH-DY2132",
          "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 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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.06
            },
            {
              "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": "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": "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": "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": "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "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": 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": "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": "AVALON HEALTHREACH WV [540415]",
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": "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": "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": "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": "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": "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": "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 CHOICE FUND-ANY CHOICE FUND [370220]",
              "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.09
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.06
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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 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": "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": "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 CHOICE [625225]",
              "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 OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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 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": "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": "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": "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": "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/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": "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": "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": "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": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.1,
              "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": 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": "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": "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 GEHA [625285]",
              "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 PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.09
            },
            {
              "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": 0.1,
              "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": 0.07
            },
            {
              "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": 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": "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": "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": "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "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 HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            }
          ]
        }
      ]
    },
    {
      "description": "Tubular Drsg Spandagrip Size F Lg Knees Med Thighs",
      "code_information": [
        {
          "code": "PX-CH-MTSAG10436",
          "type": "CDM"
        },
        {
          "code": "A6457",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.35,
          "discounted_cash": 7.38,
          "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": 7.29
            },
            {
              "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 TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.18
            },
            {
              "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": 9.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.35,
              "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": 7.29
            },
            {
              "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": 11.35,
              "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": 11.35,
              "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": 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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 8.51
            },
            {
              "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": 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": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 9.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 6.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 11.35,
              "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": 7.29
            },
            {
              "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 UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 8.29
            },
            {
              "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": 11.35,
              "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": 9.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.41
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "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": "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": "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
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 9.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 11.35,
              "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": 7.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 8.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.29
            },
            {
              "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": "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": "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": "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": "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": "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": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 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": 7.29
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.35,
              "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": 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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 9.95
            },
            {
              "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": 11.35,
              "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": 6.3
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.35,
              "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": 6.24
            },
            {
              "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": 11.35,
              "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": 7.39
            },
            {
              "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.35,
              "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": 11.35,
              "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": 6.24
            },
            {
              "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": 9.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "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": 11.35,
              "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": 11.35,
              "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": 9.65
            },
            {
              "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": 9.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.35,
              "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": 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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "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": "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.35,
              "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": 9.18
            },
            {
              "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": 3.1
            },
            {
              "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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            }
          ]
        }
      ]
    },
    {
      "description": "HC Removal Impacted Cerumen",
      "code_information": [
        {
          "code": "PX-45000025",
          "type": "CDM"
        },
        {
          "code": "69210",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1295,
          "discounted_cash": 841.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 953.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 947.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1295,
              "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": 1100.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 947.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 945.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1295
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 947.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 953.12
            },
            {
              "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": 843.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1047.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 953.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 843.05
            },
            {
              "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": 947.94
            },
            {
              "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": 813.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "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": 712.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 945.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 953.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 840.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 971.25
            },
            {
              "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": 1073.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 953.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1061.9
            },
            {
              "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": 283.61
            },
            {
              "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": 1135.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "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": 1061.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1073.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 947.94
            },
            {
              "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": 73.6,
              "estimated_amount": 953.12
            },
            {
              "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": 841.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 953.12
            },
            {
              "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": 843.05
            },
            {
              "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": 1061.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 945.35
            },
            {
              "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": 1135.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "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": 953.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 843.05
            },
            {
              "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": 951.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 971.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1061.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 953.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 840.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "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": 945.35
            },
            {
              "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": 951.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 945.35
            },
            {
              "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": 1295,
              "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": 73.6,
              "estimated_amount": 953.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 945.35
            },
            {
              "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": 947.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 947.94
            },
            {
              "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": 1139.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1061.9
            },
            {
              "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": 1100.75
            },
            {
              "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": 953.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "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": 1295,
              "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": 843.05
            },
            {
              "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": 953.12
            },
            {
              "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": 1061.9
            },
            {
              "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": 947.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 840.46
            },
            {
              "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": 813.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 951.83
            },
            {
              "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": 1295,
              "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": 353.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1100.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1061.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 971.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.26
            },
            {
              "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": 1047.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 840.46
            },
            {
              "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": 951.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1073.56
            },
            {
              "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": 1295,
              "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": 813.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1061.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC ER Level II",
      "code_information": [
        {
          "code": "PX-45000032",
          "type": "CDM"
        },
        {
          "code": "99282",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1058,
          "discounted_cash": 687.7,
          "payers_information": [
            {
              "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": 778.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 867.56
            },
            {
              "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": 149.88,
              "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": 73.2,
              "estimated_amount": 774.46
            },
            {
              "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": 687.7
            },
            {
              "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": 778.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 688.76
            },
            {
              "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": 899.3
            },
            {
              "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": 144.17,
              "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": 73.6,
              "estimated_amount": 778.69
            },
            {
              "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": 899.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 877.08
            },
            {
              "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": 231.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 778.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 778.69
            },
            {
              "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": 855.92
            },
            {
              "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": 288.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 774.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 581.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 581.9
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1058,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 774.46
            },
            {
              "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": 142.74,
              "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": 73.2,
              "estimated_amount": 774.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 774.46
            },
            {
              "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": 145.66,
              "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": 899.3
            },
            {
              "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": 1058,
              "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": 581.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 867.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 899.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 867.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 793.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "case rate",
              "standard_charge_dollar": 1263,
              "estimated_amount": 1263
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "case rate",
              "standard_charge_dollar": 1263,
              "estimated_amount": 1263
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 145.66,
              "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": 899.3
            },
            {
              "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": 778.69
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.74,
              "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": 142.74,
              "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": 899.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 144.17,
              "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": 899.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 899.3
            },
            {
              "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": 778.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 855.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 899.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 777.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 688.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 688.76
            },
            {
              "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": 142.74,
              "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": 793.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 774.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1058
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1058,
              "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": 149.88,
              "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": 774.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "case rate",
              "standard_charge_dollar": 1263,
              "estimated_amount": 1263
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 581.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 793.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 144.17,
              "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": 73.6,
              "estimated_amount": 778.69
            },
            {
              "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": 688.76
            },
            {
              "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": 149.88,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 899.3
            },
            {
              "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": 777.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 581.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 772.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 772.34
            },
            {
              "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": 142.74,
              "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": 144.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "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": 142.74,
              "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": 867.56
            },
            {
              "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": 73.6,
              "estimated_amount": 778.69
            },
            {
              "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": 867.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 899.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "case rate",
              "standard_charge_dollar": 75,
              "estimated_amount": 75
            },
            {
              "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": 774.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 688.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 772.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 778.69
            },
            {
              "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": 777.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "case rate",
              "standard_charge_dollar": 75,
              "estimated_amount": 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": 145.66,
              "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": 772.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 899.3
            },
            {
              "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": 927.87
            },
            {
              "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": 931.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 867.56
            },
            {
              "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": 867.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 581.9
            },
            {
              "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": 144.17,
              "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": 777.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 581.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 772.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 778.69
            },
            {
              "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": 867.56
            },
            {
              "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": 927.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "case rate",
              "standard_charge_dollar": 1221,
              "estimated_amount": 1221
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "case rate",
              "standard_charge_dollar": 1263,
              "estimated_amount": 1263
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 772.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 877.08
            },
            {
              "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": 877.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 778.69
            }
          ],
          "minimum": 75,
          "maximum": 1263
        }
      ]
    },
    {
      "description": "HC Bone Marrow Diagnostic Biopsy(Ies) and Aspiration(S)",
      "code_information": [
        {
          "code": "PX-36100886",
          "type": "CDM"
        },
        {
          "code": "38222",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5201,
          "discounted_cash": 3380.65,
          "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": 3339.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3900.75
            },
            {
              "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": 2480.01,
              "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": 4420.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2860.55
            },
            {
              "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": 3385.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "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": 4311.63
            },
            {
              "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": 3287.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3339.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3287.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "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": 2504.81,
              "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": 3339.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4207.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2860.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4311.63
            },
            {
              "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": 4264.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3287.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4311.63
            },
            {
              "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": 4420.85
            },
            {
              "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": 3339.04
            },
            {
              "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": 4207.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4264.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3339.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2860.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 3796.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3796.73
            },
            {
              "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": 2504.81,
              "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": 5201,
              "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": 3385.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4264.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2860.55
            },
            {
              "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": 5201,
              "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": 3287.03
            },
            {
              "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": 2530.63,
              "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": 3339.04
            },
            {
              "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": 4561.28
            },
            {
              "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": 4561.28
            },
            {
              "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": 3287.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 3796.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 5201
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 2860.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "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": 3796.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3385.85
            },
            {
              "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": 2604.01,
              "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": 5201,
              "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": 2530.63,
              "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": 4576.88
            },
            {
              "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": 3339.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 2530.63,
              "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": 1139.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2860.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3339.04
            },
            {
              "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": 4264.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3385.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 5201,
              "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": 5201,
              "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": 4420.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3796.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3287.03
            },
            {
              "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": 3339.04
            },
            {
              "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": 5201,
              "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": 2504.81,
              "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": 3796.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 3339.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3287.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 3380.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 5201
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 5201
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3385.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3900.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "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": 5201,
              "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": 3339.04
            },
            {
              "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": 2480.01,
              "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": 2504.81,
              "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": 2604.01,
              "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": 3900.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5201,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 4420.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "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": 2504.81,
              "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": 5201,
              "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": 5201,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 5201
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4264.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4420.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 5201
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2860.55
            },
            {
              "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": 2480.01,
              "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": 2480.01,
              "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": 3287.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5201,
              "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": 5201,
              "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": 1419.87
            },
            {
              "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": 2604.01,
              "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": 5201,
              "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": 3339.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4264.82
            },
            {
              "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": 5201,
              "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": 4264.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4264.82
            }
          ]
        }
      ]
    },
    {
      "description": "HC Rep Window Wedge Cast",
      "code_information": [
        {
          "code": "PX-45000046",
          "type": "CDM"
        },
        {
          "code": "45000046",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 766,
          "discounted_cash": 497.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 563.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 563.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 563.01
            },
            {
              "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": 563.01
            },
            {
              "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": 498.67
            },
            {
              "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": 628.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 421.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 559.18
            },
            {
              "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": 421.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 563.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 563.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 498.67
            },
            {
              "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": 766,
              "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": 651.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "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": 766,
              "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": 651.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "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": 481.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 421.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 619.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "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": 671.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "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": 563.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "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": 560.71
            },
            {
              "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": 481.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 497.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 574.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 421.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "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": 559.18
            },
            {
              "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": 563.78
            },
            {
              "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": 563.78
            },
            {
              "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": 563.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 559.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 628.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 559.18
            },
            {
              "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": 628.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 574.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 497.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 563.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 766,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 560.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 560.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "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": 766,
              "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": 651.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 421.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 651.1
            },
            {
              "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": 209.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 628.12
            },
            {
              "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": 635.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 560.71
            },
            {
              "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": 560.71
            },
            {
              "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": 481.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 421.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 498.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 766
            },
            {
              "payer_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": 563.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 563.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 574.5
            },
            {
              "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": 766,
              "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": 671.78
            },
            {
              "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": 674.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 628.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 651.1
            },
            {
              "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": 563.01
            },
            {
              "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": 560.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "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": 619.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 559.18
            },
            {
              "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": 628.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 628.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 481.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 497.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 563.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 498.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 560.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 421.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 497.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 628.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 560.71
            },
            {
              "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": 497.9
            },
            {
              "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": 563.01
            },
            {
              "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": 498.67
            }
          ]
        }
      ]
    },
    {
      "description": "HC Control Oropharyngeal Hemor",
      "code_information": [
        {
          "code": "PX-45000213",
          "type": "CDM"
        },
        {
          "code": "42960",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1277,
          "discounted_cash": 830.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 1277,
              "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": 1277,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "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": 348.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 957.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "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": 1119.93
            },
            {
              "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": 1277,
              "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": 1047.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "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": 1119.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 938.6
            },
            {
              "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": 1058.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "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": 934.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1277
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1058.63
            },
            {
              "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": 702.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 932.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 1085.45
            },
            {
              "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": 1033.09
            },
            {
              "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": 939.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 1277,
              "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": 1277,
              "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": 1277,
              "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": 932.21
            },
            {
              "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": 932.21
            },
            {
              "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": 938.6
            },
            {
              "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": 1277,
              "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": 831.33
            },
            {
              "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": 1277,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 1085.45
            },
            {
              "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": 1277,
              "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": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.33
            },
            {
              "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": 1047.14
            },
            {
              "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": 1047.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 957.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 957.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1033.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "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": 1085.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 1277,
              "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": 830.05
            },
            {
              "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": 939.87
            },
            {
              "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": 831.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1058.63
            },
            {
              "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": 939.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "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": 934.76
            },
            {
              "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": 1277,
              "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": 932.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "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": 938.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.21
            },
            {
              "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": 1047.14
            },
            {
              "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": 938.6
            },
            {
              "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": 1085.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "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": 1123.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 702.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 1277,
              "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": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1277,
              "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": 1047.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Enuc Excsn Ext Thrm Hemorrd",
      "code_information": [
        {
          "code": "PX-45000218",
          "type": "CDM"
        },
        {
          "code": "46320",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5506,
          "discounted_cash": 3578.9,
          "payers_information": [
            {
              "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": 4052.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3028.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 4030.39
            },
            {
              "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": 5506,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4828.76
            },
            {
              "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": 3578.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4019.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4129.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 5506,
              "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": 3584.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 4680.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4129.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5506,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 4030.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4514.92
            },
            {
              "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": 5506,
              "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": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4514.92
            },
            {
              "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": 4564.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 4030.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "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": 4514.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4680.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4514.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 5506,
              "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": 5506,
              "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": 4680.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3028.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3028.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4514.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3028.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 73.5,
              "estimated_amount": 4046.91
            },
            {
              "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": 5506,
              "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": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 4680.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 4680.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 4680.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4680.1
            },
            {
              "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": 4046.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5506
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3584.41
            },
            {
              "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": 4030.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4680.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4680.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 4030.39
            },
            {
              "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": 4845.28
            },
            {
              "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": 4046.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 5506,
              "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": 4454.35
            },
            {
              "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": 3028.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4019.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "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": 4052.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4514.92
            },
            {
              "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": 1503.14
            },
            {
              "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": 4828.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 5506,
              "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": 4680.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4019.38
            },
            {
              "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": 4019.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 4564.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3584.41
            },
            {
              "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": 5506,
              "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": 4564.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 4046.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 4680.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3584.41
            },
            {
              "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": 4454.35
            },
            {
              "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": 4514.92
            },
            {
              "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": 73.6,
              "estimated_amount": 4052.42
            },
            {
              "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": 4030.39
            },
            {
              "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": 3584.41
            },
            {
              "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": 4514.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4019.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4019.38
            },
            {
              "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": 4030.39
            },
            {
              "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": 4680.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3028.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5506,
              "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": 4129.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 4030.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3028.3
            }
          ]
        }
      ]
    },
    {
      "description": "Mask Surgical Earloop Prefferd",
      "code_information": [
        {
          "code": "PX-CH-A1-AT71021",
          "type": "CDM"
        },
        {
          "code": "A4928",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.31,
          "discounted_cash": 0.2,
          "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": 0.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.31,
              "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": 0.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.25
            },
            {
              "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": 0.31,
              "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": 0.2
            },
            {
              "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": 0.31,
              "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": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.2
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.26
            },
            {
              "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": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.23
            },
            {
              "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": 0.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.26
            },
            {
              "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": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.2
            },
            {
              "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": 0.25
            },
            {
              "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": 0.31,
              "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": 0.31,
              "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": 0.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.25
            },
            {
              "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": 0.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.26
            },
            {
              "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": 0.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.26
            },
            {
              "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": 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": 0.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.26
            },
            {
              "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": 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": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.31,
              "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": 0.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.31,
              "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": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.2
            },
            {
              "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": 0.08
            },
            {
              "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": 0.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.31
            },
            {
              "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": 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": 0.2
            },
            {
              "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": 0.25
            },
            {
              "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": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.23
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.17
            },
            {
              "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": 0.31,
              "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": 0.2
            },
            {
              "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": 0.25
            },
            {
              "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": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.27
            },
            {
              "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": 0.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.31,
              "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": 0.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.31,
              "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": 0.26
            },
            {
              "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": 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": 0.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.31,
              "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": 0.31,
              "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": 0.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.17
            }
          ]
        }
      ]
    },
    {
      "description": "HC Lung Vols Plethysmography W WO Airway Resistance",
      "code_information": [
        {
          "code": "PX-46000010",
          "type": "CDM"
        },
        {
          "code": "94726",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 188,
          "discounted_cash": 122.2,
          "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": 120.7
            },
            {
              "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": 122.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.82
            },
            {
              "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": 188,
              "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": 118.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 152.09
            },
            {
              "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": 154.16
            },
            {
              "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": 276.69,
              "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": 137.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 122.39
            },
            {
              "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": 273.95,
              "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": 188,
              "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": 188,
              "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": 159.8
            },
            {
              "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": 104.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 118.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 103.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 141
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.82
            },
            {
              "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": 122.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 155.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 155.85
            },
            {
              "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": 155.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 273.63,
              "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": 103.4
            },
            {
              "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": 268.16,
              "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": 152.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.16
            },
            {
              "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": 159.8
            },
            {
              "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": 268.16,
              "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": 273.95,
              "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": 118.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.82
            },
            {
              "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": 287.65,
              "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": 103.4
            },
            {
              "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": 276.69,
              "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": 273.63,
              "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": 188
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 141
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 120.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 273.63,
              "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": 188,
              "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": 137.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.24
            },
            {
              "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": 276.69,
              "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": 104.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 122.39
            },
            {
              "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": 104.34
            },
            {
              "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": 120.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 122.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 154.16
            },
            {
              "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": 154.16
            },
            {
              "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": 276.69,
              "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": 159.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 122.39
            },
            {
              "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": 51.32
            },
            {
              "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": 159.8
            },
            {
              "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": 188,
              "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": 141
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 188,
              "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": 159.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 120.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "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": 188,
              "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": 164.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.4
            },
            {
              "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": 287.65,
              "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": 104.34
            },
            {
              "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": 164.88
            },
            {
              "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": 118.82
            },
            {
              "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": 120.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.7
            },
            {
              "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": 188,
              "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": 103.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 276.69,
              "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": 165.44
            },
            {
              "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": 120.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 188,
              "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": 159.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 137.24
            },
            {
              "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": 301.56,
              "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": 188,
              "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": 120.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.4
            },
            {
              "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": 154.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 188,
              "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": 188,
              "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": 188,
              "additional_payer_notes": "ALL OTHER OP"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Interrogation Sq CRM",
      "code_information": [
        {
          "code": "PX-48000017",
          "type": "CDM"
        },
        {
          "code": "93291",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 125,
          "discounted_cash": 81.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.25
            },
            {
              "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": 26.25,
              "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": 79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 106.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 125,
              "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": 80.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 81.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 106.25
            },
            {
              "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": 27.29,
              "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": 109.63
            },
            {
              "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": 27.29,
              "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": 125,
              "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": 125,
              "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": 68.75
            },
            {
              "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": 26.25,
              "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": 125,
              "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": 25.99,
              "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": 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": 80.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 106.25
            },
            {
              "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": 26.25,
              "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": 25.99,
              "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": 81.38
            },
            {
              "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": 80.25
            },
            {
              "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": 25.99,
              "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": 79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.75
            },
            {
              "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": 91.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.25
            },
            {
              "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": 26.52,
              "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": 68.75
            },
            {
              "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": 125,
              "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": 80.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 103.63
            },
            {
              "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": 106.25
            },
            {
              "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": 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": 125,
              "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": 81.38
            },
            {
              "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": 102.5
            },
            {
              "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": 109.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.25
            },
            {
              "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": 27.29,
              "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": 125,
              "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": 79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 69.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 25.99,
              "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": 125,
              "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": 91.25
            },
            {
              "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": 26.25,
              "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": 125,
              "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": 68.75
            },
            {
              "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": 26.25,
              "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": 125,
              "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": 69.38
            },
            {
              "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": 81.25
            },
            {
              "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": 69.38
            },
            {
              "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": 106.25
            },
            {
              "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": 81.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 81.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 102.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 106.25
            },
            {
              "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": 110
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 103.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.25
            },
            {
              "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": 79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 80.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.25
            },
            {
              "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": 101.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.5
            },
            {
              "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": 26.52,
              "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": 102.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 93.75
            },
            {
              "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": 26.52,
              "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": 80.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 93.75
            },
            {
              "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": 68.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 125,
              "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": 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": 80.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 106.25
            },
            {
              "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": 125,
              "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": 68.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 125
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 103.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 101.13
            },
            {
              "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": 34.13
            },
            {
              "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": 125,
              "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": 79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 93.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Right Ventricular Recording",
      "code_information": [
        {
          "code": "PX-48000026",
          "type": "CDM"
        },
        {
          "code": "93603",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7257,
          "discounted_cash": 4717.05,
          "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": 4658.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4658.99
            },
            {
              "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": 1067.62,
              "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": 4724.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3991.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5297.61
            },
            {
              "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": 5950.74
            },
            {
              "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": 1016.78,
              "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": 4586.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 6168.45
            },
            {
              "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": 6016.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5297.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 6168.45
            },
            {
              "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": 5950.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 7257,
              "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": 7257
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4658.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4724.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 4027.64
            },
            {
              "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": 1589.28
            },
            {
              "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": 4724.31
            },
            {
              "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": 5950.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 4027.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3991.35
            },
            {
              "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": 1049.12,
              "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": 6168.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5297.61
            },
            {
              "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": 7257,
              "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": 6168.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6168.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4658.99
            },
            {
              "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": 4658.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5950.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4586.42
            },
            {
              "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": 4717.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5442.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 6168.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6168.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 7257,
              "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": 1016.78,
              "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": 4658.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 5297.61
            },
            {
              "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": 1049.12,
              "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": 63.2,
              "estimated_amount": 4586.42
            },
            {
              "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": 7257,
              "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": 7257,
              "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": 6386.16
            },
            {
              "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": 7257,
              "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": 7257,
              "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": 5297.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6016.05
            },
            {
              "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": 1016.78,
              "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": 6364.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 4658.99
            },
            {
              "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": 4658.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5950.74
            },
            {
              "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": 5870.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4027.64
            },
            {
              "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": 1049.12,
              "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": 1090.67,
              "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": 6016.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5950.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 6168.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3991.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3991.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6168.45
            },
            {
              "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": 6364.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 1037.53,
              "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": 4658.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5950.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5950.74
            },
            {
              "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": 1016.78,
              "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": 1037.53,
              "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": 6168.45
            },
            {
              "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": 3991.35
            },
            {
              "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": 1049.12,
              "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": 1090.67,
              "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": 4586.42
            },
            {
              "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": 1037.53,
              "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": 4658.99
            },
            {
              "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": 1049.12,
              "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": 7257,
              "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": 5870.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6168.45
            },
            {
              "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": 4027.64
            },
            {
              "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": 4724.31
            },
            {
              "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": 4586.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3991.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6168.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 5442.75
            },
            {
              "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": 6168.45
            },
            {
              "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": 6168.45
            },
            {
              "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": 4586.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4586.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 5442.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4658.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5297.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4658.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7257,
              "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": 1981.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4724.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4586.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3991.35
            }
          ]
        }
      ]
    },
    {
      "description": "Ep Eval W Ablation Svt Including 3d Mapping",
      "code_information": [
        {
          "code": "PX-48000042",
          "type": "CDM"
        },
        {
          "code": "93653",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63198,
          "discounted_cash": 41078.7,
          "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": 40573.12
            },
            {
              "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": 41141.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 63198,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 13840.36
            },
            {
              "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": 63198,
              "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": 47398.5
            },
            {
              "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": 46134.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53718.3
            },
            {
              "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": 63198,
              "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": 63198,
              "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": 51822.36
            },
            {
              "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": 51822.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51822.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40573.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51822.36
            },
            {
              "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": 40573.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40573.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40573.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51822.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53718.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34758.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53718.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39941.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 41141.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41141.9
            },
            {
              "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": 55424.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39941.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 35074.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34758.9
            },
            {
              "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": 20936.3,
              "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": 20729.01,
              "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": 39941.14
            },
            {
              "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": 20936.3,
              "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": 35074.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 63198
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39941.14
            },
            {
              "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": 40573.12
            },
            {
              "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": 41141.9
            },
            {
              "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": 51127.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46134.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53718.3
            },
            {
              "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": 21765.46,
              "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": 63198,
              "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": 46134.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20936.3,
              "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": 52391.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53718.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34758.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40573.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51822.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46134.54
            },
            {
              "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": 20729.01,
              "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": 63198,
              "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": 63198,
              "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": 63198,
              "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": 53718.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34758.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34758.9
            },
            {
              "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": 21765.46,
              "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": 52391.14
            },
            {
              "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": 34758.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 21765.46,
              "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": 20936.3,
              "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": 40573.12
            },
            {
              "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": 20729.01,
              "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": 21152.05,
              "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": 41078.7
            },
            {
              "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": 35074.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 40573.12
            },
            {
              "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": 35074.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47398.5
            },
            {
              "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": 53718.3
            },
            {
              "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": 39941.14
            },
            {
              "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": 39941.14
            },
            {
              "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": 63198,
              "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": 53718.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 17253.05
            },
            {
              "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": 20729.01,
              "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": 40573.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47398.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46134.54
            },
            {
              "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": 63198,
              "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": 52391.14
            },
            {
              "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": 55424.65
            },
            {
              "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": 55614.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39941.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34758.9
            },
            {
              "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": 21152.05,
              "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": 53718.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41141.9
            },
            {
              "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": 51822.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40573.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 63198,
              "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": 21152.05,
              "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": 40573.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53718.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53718.3
            },
            {
              "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": 20936.3,
              "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": 53718.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39941.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 63198,
              "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": 51822.36
            },
            {
              "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": 53718.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 53718.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 63198,
              "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": 46134.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51127.18
            }
          ]
        }
      ]
    },
    {
      "description": "Left Heart Cath by Transseptal or Transapical Puncture Add On",
      "code_information": [
        {
          "code": "PX-48100028",
          "type": "CDM"
        },
        {
          "code": "93462",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10643,
          "discounted_cash": 6917.95,
          "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": 6832.81
            },
            {
              "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": 5853.65
            },
            {
              "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": 9365.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9046.55
            },
            {
              "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": 6726.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6832.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6832.81
            },
            {
              "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": 8727.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5853.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7769.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6832.81
            },
            {
              "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": 9046.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9046.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5853.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6832.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 8727.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9046.55
            },
            {
              "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": 10643,
              "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": 6726.38
            },
            {
              "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": 10643,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7769.39
            },
            {
              "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": 8610.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10643,
              "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": 7769.39
            },
            {
              "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": 6832.81
            },
            {
              "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": 6928.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8727.26
            },
            {
              "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": 6726.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 5853.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9046.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10643,
              "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": 9333.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6832.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9046.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7982.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8727.26
            },
            {
              "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": 2905.54
            },
            {
              "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": 10643,
              "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": 10643,
              "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": 9333.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 10643,
              "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": 6832.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8727.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7769.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9046.55
            },
            {
              "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": 10643,
              "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": 10643,
              "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": 10643,
              "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": 6726.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 10643,
              "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": 9046.55
            },
            {
              "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": 6832.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8610.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 10643,
              "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": 10643,
              "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": 6917.95
            },
            {
              "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": 10643,
              "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": 10643,
              "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": 6726.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 9046.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9046.55
            },
            {
              "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": 6832.81
            },
            {
              "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": 10643,
              "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": 7982.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 7769.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 6832.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8823.05
            },
            {
              "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": 9046.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7769.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 10643,
              "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": 6928.59
            },
            {
              "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": 8727.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6928.59
            },
            {
              "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": 10643,
              "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": 10643,
              "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": 7982.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8727.26
            },
            {
              "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": 10643,
              "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": 9046.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6726.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5853.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5853.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 6832.81
            },
            {
              "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": 6928.59
            },
            {
              "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": 10643,
              "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": 2330.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6726.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 10643,
              "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": 9046.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8823.05
            },
            {
              "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": 8727.26
            },
            {
              "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": 10643,
              "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": 8823.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10643,
              "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": 6928.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10643,
              "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": 9046.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6726.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5853.65
            },
            {
              "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": 10643,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC De Stent W Atherectomyaddl Branch",
      "code_information": [
        {
          "code": "PX-48100038",
          "type": "CDM"
        },
        {
          "code": "C9603",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15784,
          "discounted_cash": 10259.6,
          "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": 10133.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10275.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10275.38
            },
            {
              "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": 12769.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 15784,
              "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": 11522.32
            },
            {
              "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": 15784,
              "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": 10133.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9975.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9975.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13084.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12942.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 8681.2
            },
            {
              "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": 11522.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11838
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9975.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 8681.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10133.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10133.33
            },
            {
              "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": 9975.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 13416.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 13084.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10133.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10133.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 13842.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11522.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10133.33
            },
            {
              "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": 13084.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12942.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8681.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11838
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 10133.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 13416.4
            },
            {
              "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": 13889.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8681.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8681.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 13416.4
            },
            {
              "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": 10133.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12769.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8681.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11522.32
            },
            {
              "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": 13416.4
            },
            {
              "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": 10275.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11838
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13842.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "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": 15784,
              "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": 8681.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10275.38
            },
            {
              "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": 12942.88
            },
            {
              "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": 12942.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "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": 10275.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12942.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 15784,
              "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": 15784,
              "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": 15784,
              "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": 15784,
              "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": 15784,
              "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": 11522.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11522.32
            },
            {
              "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": 9975.49
            },
            {
              "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": 15784,
              "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": 15784,
              "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": 10259.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "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": 12942.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15784,
              "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": 15784,
              "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": 10133.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13416.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9975.49
            },
            {
              "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": 9975.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10133.33
            },
            {
              "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": 4309.03
            },
            {
              "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": 10133.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9975.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12942.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12942.88
            }
          ]
        }
      ]
    },
    {
      "description": "HC Revasc Cabg De Stent",
      "code_information": [
        {
          "code": "PX-48100039",
          "type": "CDM"
        },
        {
          "code": "C9604",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17209,
          "discounted_cash": 11185.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11048.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11048.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11203.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9464.95
            },
            {
              "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": 9697.66,
              "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": 17209,
              "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": 11048.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14111.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14111.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14111.38
            },
            {
              "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": 9464.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12562.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9464.95
            },
            {
              "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": 17209,
              "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": 17209,
              "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": 17209,
              "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": 17209,
              "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": 10876.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "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": 11048.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12906.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9464.95
            },
            {
              "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": 11048.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14111.38
            },
            {
              "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": 15143.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9464.95
            },
            {
              "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": 12562.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 10876.09
            },
            {
              "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": 9797.6,
              "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": 17209,
              "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": 10081.73,
              "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": 9464.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 17209
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 17209
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 14266.26
            },
            {
              "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": 17209,
              "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": 11048.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12562.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14266.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12906.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 17209
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11203.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 17209,
              "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": 9601.65,
              "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": 4698.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11203.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 12562.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "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": 9601.65,
              "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": 13922.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "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": 15092.29
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "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": 11048.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11048.18
            },
            {
              "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": 11048.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 14627.65
            },
            {
              "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": 9697.66,
              "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": 17209,
              "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": 17209,
              "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": 14111.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14111.38
            },
            {
              "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": 14627.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11048.18
            },
            {
              "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": 10081.73,
              "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": 15092.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 11048.18
            },
            {
              "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": 11203.06
            },
            {
              "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": 11048.18
            },
            {
              "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": 9601.65,
              "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": 17209,
              "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": 14627.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12906.75
            },
            {
              "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": 10876.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "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": 14627.65
            },
            {
              "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": 17209,
              "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": 9697.66,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 17209
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 17209
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14627.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 9797.6,
              "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": 9697.66,
              "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": 10081.73,
              "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": 13922.08
            },
            {
              "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": 14111.38
            },
            {
              "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": 14266.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10876.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10876.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10876.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12562.57
            },
            {
              "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": 11185.85
            },
            {
              "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": 17209,
              "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": 9797.6,
              "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": 10876.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 9601.65,
              "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": 3768.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9464.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11203.06
            },
            {
              "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": 10876.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12562.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14111.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17209,
              "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": 9697.66,
              "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": 14627.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC Echo Limited or Follow Up",
      "code_information": [
        {
          "code": "PX-48300005",
          "type": "CDM"
        },
        {
          "code": "93308",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1725,
          "discounted_cash": 1121.25,
          "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": 1107.45
            },
            {
              "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": 1107.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 216,
              "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": 1414.5
            },
            {
              "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": 1414.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 1466.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1107.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1090.2
            },
            {
              "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": 1725,
              "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": 1725,
              "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": 948.75
            },
            {
              "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": 1466.25
            },
            {
              "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": 1725,
              "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": 957.38
            },
            {
              "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": 1107.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 1725,
              "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": 948.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 948.75
            },
            {
              "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": 1414.5
            },
            {
              "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": 1090.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 1725,
              "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": 1466.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1466.25
            },
            {
              "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": 1518
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1466.25
            },
            {
              "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": 213.87,
              "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": 1122.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1293.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1725
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 948.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1259.25
            },
            {
              "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": 224.56,
              "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": 1466.25
            },
            {
              "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": 216,
              "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": 1090.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 1107.45
            },
            {
              "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": 1122.98
            },
            {
              "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": 1122.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 948.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 948.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1090.2
            },
            {
              "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": 1090.2
            },
            {
              "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": 1395.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 948.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 218.23,
              "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": 1466.25
            },
            {
              "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": 1466.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1466.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1107.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1107.45
            },
            {
              "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": 216,
              "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": 1107.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1122.98
            },
            {
              "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": 213.87,
              "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": 1090.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1090.2
            },
            {
              "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": 1725,
              "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": 1512.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1466.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1107.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1414.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 1259.25
            },
            {
              "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": 957.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1430.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1122.98
            },
            {
              "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": 1259.25
            },
            {
              "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": 957.38
            },
            {
              "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": 1512.83
            },
            {
              "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": 1107.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 1466.25
            },
            {
              "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": 218.23,
              "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": 1414.5
            },
            {
              "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": 213.87,
              "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": 1090.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1259.25
            },
            {
              "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": 1725,
              "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": 1259.25
            },
            {
              "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": 224.56,
              "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": 1430.03
            },
            {
              "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": 1414.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1466.25
            },
            {
              "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": 216,
              "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": 1725,
              "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": 1725,
              "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": 1725,
              "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": 213.87,
              "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": 1725,
              "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": 1293.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1466.25
            },
            {
              "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": 1107.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1395.53
            },
            {
              "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": 224.56,
              "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": 377.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1107.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1414.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1430.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1725,
              "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": 1725,
              "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": 216,
              "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": 1121.25
            },
            {
              "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": 218.23,
              "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": 1414.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1293.75
            },
            {
              "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": 470.93
            },
            {
              "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": 957.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1466.25
            },
            {
              "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": 1725,
              "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": 1259.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Echo Color Flow Velocity Mapping Add On",
      "code_information": [
        {
          "code": "PX-48300011",
          "type": "CDM"
        },
        {
          "code": "93325",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 222,
          "discounted_cash": 144.3,
          "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": 142.52
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 222,
              "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": 222,
              "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": 188.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 222,
              "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": 188.7
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 222,
              "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": 162.06
            },
            {
              "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": 222,
              "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": 188.7
            },
            {
              "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": 222,
              "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": 222,
              "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": 123.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 222,
              "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": 182.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 188.7
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 162.06
            },
            {
              "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": 144.52
            },
            {
              "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": 222,
              "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": 140.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 184.04
            },
            {
              "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": 222,
              "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": 140.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 144.3
            },
            {
              "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": 195.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "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": 182.04
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 179.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 222,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "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": 182.04
            },
            {
              "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": 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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 222,
              "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": 142.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "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": 142.52
            },
            {
              "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": 60.61
            },
            {
              "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": 140.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 188.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 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": "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": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 179.6
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 222,
              "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": 222,
              "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": 166.5
            },
            {
              "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": 142.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "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": 123.21
            },
            {
              "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": 222,
              "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": 166.5
            },
            {
              "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": 142.52
            },
            {
              "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": 184.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "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": 194.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 222,
              "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": 182.04
            },
            {
              "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": 140.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 162.06
            },
            {
              "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": 188.7
            },
            {
              "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": 222,
              "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": 122.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 142.52
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 144.52
            },
            {
              "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": 222,
              "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": 122.1
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 184.04
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "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": 222,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 222,
              "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": 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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 222,
              "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": 222,
              "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": 142.52
            },
            {
              "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": 144.52
            },
            {
              "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": 142.52
            },
            {
              "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": 194.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 222,
              "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": 222,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fetal Non Stress Test",
      "code_information": [
        {
          "code": "PX-51000024",
          "type": "CDM"
        },
        {
          "code": "59025",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 852,
          "discounted_cash": 553.8,
          "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": 546.98
            },
            {
              "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": 698.64
            },
            {
              "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": 852,
              "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": 852,
              "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": 852,
              "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": 852,
              "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": 472.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "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": 175.66,
              "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": 538.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 468.6
            },
            {
              "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": 852,
              "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": 852,
              "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": 852,
              "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": 724.2
            },
            {
              "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": 173.92,
              "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": 546.98
            },
            {
              "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": 538.46
            },
            {
              "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": 177.47,
              "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": 554.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 472.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 852,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 689.27
            },
            {
              "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": 177.47,
              "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": 749.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 538.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 852,
              "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": 173.92,
              "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": 554.65
            },
            {
              "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": 546.98
            },
            {
              "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": 538.46
            },
            {
              "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": 706.31
            },
            {
              "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": 175.66,
              "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": 747.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "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": 472.86
            },
            {
              "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": 852,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 852
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 689.27
            },
            {
              "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": 852,
              "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": 468.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 468.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 852,
              "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": 538.46
            },
            {
              "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": 177.47,
              "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": 621.96
            },
            {
              "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": 621.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 639
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 173.92,
              "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": 175.66,
              "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": 724.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 468.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 621.96
            },
            {
              "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": 538.46
            },
            {
              "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": 747.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 621.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 538.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 621.96
            },
            {
              "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": 546.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 698.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 724.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 639
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "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": 698.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 468.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 706.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 175.66,
              "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": 724.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 698.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 173.92,
              "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": 724.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 546.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 554.65
            },
            {
              "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": 554.65
            },
            {
              "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": 546.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 554.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 639
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 621.96
            },
            {
              "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": 698.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 698.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 706.31
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 538.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 468.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 724.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 546.98
            },
            {
              "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": 468.6
            },
            {
              "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": 182.61,
              "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": 472.86
            },
            {
              "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": 546.98
            },
            {
              "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": 175.66,
              "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": 546.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 698.64
            },
            {
              "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": 553.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 852,
              "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": 724.2
            },
            {
              "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": 546.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 698.64
            },
            {
              "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": 182.61,
              "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": 182.61,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 852,
          "payers_information": [
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 232.6
            }
          ]
        }
      ]
    },
    {
      "description": "HC Visit OP Estab Level 3",
      "code_information": [
        {
          "code": "PX-51000052",
          "type": "CDM"
        },
        {
          "code": "G0463",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 185,
          "discounted_cash": 120.25,
          "payers_information": [
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "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": 185,
              "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": 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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 185,
              "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": 157.25
            },
            {
              "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": 118.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "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": 120.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 185,
              "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": 185,
              "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": 185,
              "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": 185
            },
            {
              "payer_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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 121.14,
              "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": 112.94,
              "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": 153.37
            },
            {
              "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": 151.7
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.28,
              "estimated_amount": 30.28
            },
            {
              "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": 102.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 185,
              "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": 185,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 153.37
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 185,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "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": "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": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "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": "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": "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 MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.94,
              "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": 185,
              "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": 101.75
            },
            {
              "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": 118.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "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": 121.14,
              "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": 151.7
            },
            {
              "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": 112.94,
              "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": 118.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 185,
              "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": 157.25
            },
            {
              "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": 101.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 151.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "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": 116.53,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 157.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "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": 127,
              "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": 120.44
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 116.53,
              "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": 120.44
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.94,
              "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": 185,
              "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": 120.25
            },
            {
              "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": 149.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "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": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 102.68
            },
            {
              "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": 102.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 185,
              "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": 185,
              "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": 116.53,
              "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": 102.68
            },
            {
              "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": 115.24,
              "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": 118.77
            },
            {
              "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "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": 185,
              "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": 118.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "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": 162.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.28,
              "estimated_amount": 30.28
            },
            {
              "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": "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": "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": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 92.02,
              "estimated_amount": 92.02
            },
            {
              "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": 185,
              "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": 157.25
            },
            {
              "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": 151.7
            },
            {
              "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": 115.24,
              "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": 115.24,
              "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": 116.53,
              "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": 157.25
            },
            {
              "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": 116.53,
              "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": 153.37
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            }
          ],
          "minimum": 30.28,
          "maximum": 92.02
        }
      ]
    },
    {
      "description": "HC MRI Low Extrem Non Joint WO Contrast",
      "code_information": [
        {
          "code": "PX-61400013",
          "type": "CDM"
        },
        {
          "code": "73718",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1719,
          "discounted_cash": 1117.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1119.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1390.67
            },
            {
              "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": 376.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "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": 1390.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1289.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1289.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "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": 1119.07
            },
            {
              "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": 218.23,
              "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": 1461.15
            },
            {
              "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": 469.29
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "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": 1119.07
            },
            {
              "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": 1409.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 1719,
              "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": 1254.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1254.87
            },
            {
              "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": 1461.15
            },
            {
              "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": 1265.18
            },
            {
              "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": 1258.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1409.58
            },
            {
              "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": 1258.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1258.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 73.2,
              "estimated_amount": 1258.31
            },
            {
              "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": 1461.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1263.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1289.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "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": 1507.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 945.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 1719,
              "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": 1254.87
            },
            {
              "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": 1254.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 216,
              "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": 1719,
              "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": 1409.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 216,
              "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": 1719
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 945.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "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": 1409.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 216,
              "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": 73.5,
              "estimated_amount": 1263.47
            },
            {
              "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": 1263.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1425.05
            },
            {
              "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": 1512.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1409.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1409.58
            },
            {
              "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": 224.56,
              "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": 1719,
              "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": 945.45
            },
            {
              "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": 216,
              "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": 1461.15
            },
            {
              "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": 218.23,
              "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": 1719,
              "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": 1719,
              "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": 1719,
              "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": 213.87,
              "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": 224.56,
              "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": 1719,
              "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": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "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": 1507.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1258.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 1425.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1425.05
            },
            {
              "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": 1719,
              "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": 224.56,
              "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": 73.2,
              "estimated_amount": 1258.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1119.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1409.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1409.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 945.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 945.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1254.87
            },
            {
              "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": 213.87,
              "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": 1117.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1119.07
            },
            {
              "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": 216,
              "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": 213.87,
              "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": 945.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 945.45
            },
            {
              "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": 73.6,
              "estimated_amount": 1265.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "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": 1265.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            },
            {
              "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": 1263.47
            },
            {
              "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": 1265.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1258.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1719,
              "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": 1719,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1258.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1254.87
            },
            {
              "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": 213.87,
              "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": 1719,
              "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": 218.23,
              "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": 1461.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1461.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Breast Unilat W and WO Contrast",
      "code_information": [
        {
          "code": "PX-61400032",
          "type": "CDM"
        },
        {
          "code": "77048",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2281,
          "discounted_cash": 1482.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "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": 1678.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 1665.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "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": 1678.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1669.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 73.2,
              "estimated_amount": 1669.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 2281,
              "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": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 2281,
              "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": 1710.75
            },
            {
              "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": 1678.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1669.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1484.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1669.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 1938.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2281
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "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": 2281,
              "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": 2281,
              "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": 1254.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1254.55
            },
            {
              "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": 2281,
              "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": 1938.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1890.95
            },
            {
              "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": 1870.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1665.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1669.69
            },
            {
              "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": 1845.33
            },
            {
              "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": 1870.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1870.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 2281,
              "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": 2281,
              "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": 2007.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1254.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1254.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1890.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1665.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 1938.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1870.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1710.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1254.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 2281,
              "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": 1484.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1665.13
            },
            {
              "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": 1676.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1254.55
            },
            {
              "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": 1665.13
            },
            {
              "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": 1484.93
            },
            {
              "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": 622.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 1870.42
            },
            {
              "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": 2000.44
            },
            {
              "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": 1669.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "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": 2000.44
            },
            {
              "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": 2281,
              "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": 73.5,
              "estimated_amount": 1676.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1665.13
            },
            {
              "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": 1890.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "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": 1484.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "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": 1676.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1254.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "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": 2281,
              "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": 1845.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1870.42
            },
            {
              "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": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "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": 1669.69
            },
            {
              "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": 1669.69
            },
            {
              "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": 1482.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1870.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1678.82
            },
            {
              "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": 1678.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1676.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1484.93
            },
            {
              "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": 1870.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1938.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2281,
              "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": 1710.75
            },
            {
              "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": 1938.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mra Pelvis WO Contrast",
      "code_information": [
        {
          "code": "PX-61800010",
          "type": "CDM"
        },
        {
          "code": "72198",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1872,
          "discounted_cash": 1216.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "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": 409.97
            },
            {
              "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": 1370.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1872
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1029.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1366.56
            },
            {
              "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": 1218.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1404
            },
            {
              "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": 1370.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1370.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "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": 1535.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "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": 1872,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1375.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1029.6
            },
            {
              "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": 216,
              "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": 1591.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 1872,
              "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": 1647.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 1872,
              "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": 1029.6
            },
            {
              "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": 1029.6
            },
            {
              "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": 216,
              "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": 224.56,
              "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": 213.87,
              "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": 216,
              "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": 1375.92
            },
            {
              "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": 1375.92
            },
            {
              "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": 1872,
              "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": 1535.04
            },
            {
              "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": 1872,
              "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": 1872,
              "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": 1872,
              "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": 1591.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1551.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 1872,
              "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": 1218.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1535.04
            },
            {
              "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": 1366.56
            },
            {
              "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": 1872,
              "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": 1872,
              "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": 1872,
              "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": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 73.2,
              "estimated_amount": 1370.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 1872,
              "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": 1591.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1404
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "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": 1377.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1029.6
            },
            {
              "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": 224.56,
              "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": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "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": 1377.79
            },
            {
              "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": 1641.74
            },
            {
              "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": 1370.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1218.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1514.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1370.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1366.56
            },
            {
              "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": 213.87,
              "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": 1366.56
            },
            {
              "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": 216,
              "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": 73.2,
              "estimated_amount": 1370.3
            },
            {
              "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": 1641.74
            },
            {
              "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": 218.23,
              "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": 1551.89
            },
            {
              "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": 213.87,
              "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": 1872,
              "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": 218.23,
              "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": 1591.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1535.04
            },
            {
              "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": 213.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1377.79
            },
            {
              "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": 511.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1366.56
            },
            {
              "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": 216,
              "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": 1591.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1218.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1366.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "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": 1377.79
            },
            {
              "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": 1218.67
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 240.64,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 252.67,
              "additional_payer_notes": "PHYSICIAN 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": 1404
            },
            {
              "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": 1377.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1551.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 1029.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1535.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1029.6
            },
            {
              "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": 1591.2
            },
            {
              "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": 1216.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1872,
              "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": 1514.45
            },
            {
              "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": 1535.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 73.2,
              "estimated_amount": 1370.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1535.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1591.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1872,
              "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": 218.23,
              "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": 73.5,
              "estimated_amount": 1375.92
            },
            {
              "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": 1535.04
            }
          ],
          "minimum": 240.64,
          "maximum": 240.64
        }
      ]
    },
    {
      "description": "HC Mra Pelvis W and WO Contrast",
      "code_information": [
        {
          "code": "PX-61800011",
          "type": "CDM"
        },
        {
          "code": "72198",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2658,
          "discounted_cash": 1727.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2150.32
            },
            {
              "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": 2331.07
            },
            {
              "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": 1956.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2259.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2259.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2203.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1945.66
            },
            {
              "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": 2658,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 2179.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 342.5,
              "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": 2259.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1953.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1461.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1940.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1940.34
            },
            {
              "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": 1953.63
            },
            {
              "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": 352.43,
              "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": 339.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2259.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2203.48
            },
            {
              "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": 2658,
              "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": 339.01,
              "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": 335.65,
              "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": 2179.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 2259.3
            },
            {
              "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": 1940.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1940.34
            },
            {
              "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": 352.43,
              "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": 1993.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1730.36
            },
            {
              "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": 2179.56
            },
            {
              "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": 1953.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1461.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1461.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 2259.3
            },
            {
              "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": 1730.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1461.9
            },
            {
              "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": 1945.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1461.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 2259.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 240.64,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 252.67,
              "additional_payer_notes": "PHYSICIAN 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": 1940.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1945.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 73.2,
              "estimated_amount": 1945.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1730.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2259.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2658
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1945.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1461.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2179.56
            },
            {
              "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": 339.01,
              "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": 2658,
              "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": 2339.04
            },
            {
              "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": 335.65,
              "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": 2179.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1945.66
            },
            {
              "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": 2658,
              "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": 582.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2259.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1940.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2259.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1993.5
            },
            {
              "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": 1953.63
            },
            {
              "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": 1730.36
            },
            {
              "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": 1945.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "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": 725.63
            },
            {
              "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": 2179.56
            },
            {
              "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": 335.65,
              "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": 2658,
              "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": 2658,
              "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": 2658,
              "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": 2658,
              "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": 2658,
              "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": 1727.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2658,
              "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": 2259.3
            },
            {
              "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": 335.65,
              "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": 342.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1730.36
            },
            {
              "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": 2179.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1993.5
            },
            {
              "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": 2259.3
            },
            {
              "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": 2259.3
            },
            {
              "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": 2658,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "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": 1956.29
            },
            {
              "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": 73.6,
              "estimated_amount": 1956.29
            },
            {
              "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": 1956.29
            },
            {
              "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": 2331.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2259.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 339.01,
              "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": 2658,
              "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": 2658,
              "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": 342.5,
              "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": 2203.48
            },
            {
              "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": 1461.9
            },
            {
              "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": 2150.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1945.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2658,
              "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": 2658,
              "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": 339.01,
              "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": 2179.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1956.29
            }
          ],
          "minimum": 240.64,
          "maximum": 240.64
        }
      ]
    },
    {
      "description": "HC Eeg Monitor 61 to 119 Minutes",
      "code_information": [
        {
          "code": "PX-74000002",
          "type": "CDM"
        },
        {
          "code": "95813",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1815,
          "discounted_cash": 1179.75,
          "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": 1165.23
            },
            {
              "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": 1815,
              "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": 1815,
              "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": 1542.75
            },
            {
              "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": 1488.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1324.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 998.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1468.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1815,
              "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": 1147.08
            },
            {
              "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": 1181.57
            },
            {
              "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": 1147.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 998.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1504.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1504.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1165.23
            },
            {
              "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": 1468.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1007.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1147.08
            },
            {
              "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": 1165.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1181.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1147.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1815,
              "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": 998.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1324.95
            },
            {
              "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": 1815,
              "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": 1488.3
            },
            {
              "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": 1007.33
            },
            {
              "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": 1324.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1361.25
            },
            {
              "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": 1597.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1147.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1361.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1324.95
            },
            {
              "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": 276.69,
              "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": 1542.75
            },
            {
              "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": 1504.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1815,
              "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": 1815,
              "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": 1324.95
            },
            {
              "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": 276.69,
              "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": 287.65,
              "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": 1488.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1181.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1181.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1542.75
            },
            {
              "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": 1147.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "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": 1181.57
            },
            {
              "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": 495.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 273.95,
              "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": 1815,
              "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": 1815,
              "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": 276.69,
              "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": 276.69,
              "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": 1165.23
            },
            {
              "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": 1165.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1488.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1815
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1488.3
            },
            {
              "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": 287.65,
              "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": 1007.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1361.25
            },
            {
              "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": 287.65,
              "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": 1815,
              "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": 1165.23
            },
            {
              "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": 1488.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 998.25
            },
            {
              "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": 1147.08
            },
            {
              "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": 1179.75
            },
            {
              "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": 397.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1815,
              "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": 1165.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1324.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1165.23
            },
            {
              "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": 1591.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1591.76
            },
            {
              "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": 279.54,
              "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": 273.95,
              "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": 1165.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1815,
              "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": 1007.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1165.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 998.25
            },
            {
              "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": 1815,
              "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": 1488.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1488.3
            },
            {
              "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": 279.54,
              "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": 1542.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "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": 279.54,
              "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": 998.25
            },
            {
              "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": 276.69,
              "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": 273.95,
              "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": 998.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1147.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1542.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1165.23
            },
            {
              "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": 1542.75
            },
            {
              "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": 273.95,
              "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": 1165.23
            }
          ]
        }
      ]
    },
    {
      "description": "HC Egd W Biopsy",
      "code_information": [
        {
          "code": "PX-75000015",
          "type": "CDM"
        },
        {
          "code": "43239",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4681,
          "discounted_cash": 3042.65,
          "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": 3005.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3047.33
            },
            {
              "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": 3838.42
            },
            {
              "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": 3838.42
            },
            {
              "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": 4681,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3098.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3417.13
            },
            {
              "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": 3978.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3005.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3098.82
            },
            {
              "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": 3042.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4681,
              "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": 2574.55
            },
            {
              "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": 3838.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "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": 2574.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3838.42
            },
            {
              "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": 1277.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4681,
              "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": 2574.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3417.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3047.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "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": 1025.14
            },
            {
              "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": 3047.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3510.75
            },
            {
              "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": 3047.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "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": 2958.39
            },
            {
              "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": 4105.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3098.82
            },
            {
              "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": 4681,
              "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": 3978.85
            },
            {
              "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": 3005.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3005.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3786.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3047.33
            },
            {
              "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": 3005.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4681,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2958.39
            },
            {
              "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": 3880.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3005.2
            },
            {
              "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": 2958.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "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": 2958.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2958.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3417.13
            },
            {
              "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": 4681,
              "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": 4681,
              "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": 3978.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4681,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3880.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3005.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2958.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3098.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3510.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3005.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3838.42
            },
            {
              "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": 3978.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3838.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3417.13
            },
            {
              "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": 3005.2
            },
            {
              "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": 3005.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3510.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4681,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2958.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3417.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "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": 3417.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3005.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3880.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3838.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2958.39
            },
            {
              "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": 4119.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "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": 3005.2
            },
            {
              "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": 3786.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2991.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            },
            {
              "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": 4105.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4681,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2574.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3838.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3978.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC Small Intestine Endoscopy W J Tube Plcmnt",
      "code_information": [
        {
          "code": "PX-75000055",
          "type": "CDM"
        },
        {
          "code": "44372",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5835,
          "discounted_cash": 3792.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3746.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4259.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4784.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5835,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5835,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5835,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3746.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5835
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3687.72
            },
            {
              "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": 4259.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5835,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5835
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5835,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4837.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5835
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4259.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3798.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4784.7
            },
            {
              "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": 1592.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4376.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3746.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3209.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3746.07
            },
            {
              "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": 3798.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "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": 3746.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3798.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "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": 3687.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4259.55
            },
            {
              "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": 3746.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4784.7
            },
            {
              "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": 4959.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3687.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3792.75
            },
            {
              "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": 4784.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3746.07
            },
            {
              "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": 4784.7
            },
            {
              "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": 3687.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3209.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3746.07
            },
            {
              "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": 4720.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3209.25
            },
            {
              "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": 3209.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3687.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "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": 4837.22
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3209.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4376.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3209.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3687.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5835
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "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": 5835,
              "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": 4837.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "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": 5835,
              "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": 3746.07
            },
            {
              "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": 3798.59
            },
            {
              "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": 3687.72
            },
            {
              "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": 5117.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5835,
              "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": 3746.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4259.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4376.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3687.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4259.55
            },
            {
              "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": 3746.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4720.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4784.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5835
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4959.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3798.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5835,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5835,
              "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": 3746.07
            },
            {
              "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": 5117.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3209.25
            },
            {
              "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": 4784.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4784.7
            },
            {
              "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": 5134.8
            }
          ]
        }
      ]
    },
    {
      "description": "Small Intestine Endoscopy Including Ileum W/ Control Bleeding",
      "code_information": [
        {
          "code": "PX-75000059",
          "type": "CDM"
        },
        {
          "code": "44378",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5845,
          "discounted_cash": 3799.25,
          "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": 3752.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4792.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3869.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5845,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5845,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3694.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3869.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "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": 4792.9
            },
            {
              "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": 3752.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4266.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4845.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3752.49
            },
            {
              "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": 4728.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "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": 5845,
              "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": 5143.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3214.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3214.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3752.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4792.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3869.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4845.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3214.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3694.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3214.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4266.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3694.04
            },
            {
              "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": 3694.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "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": 4845.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4383.75
            },
            {
              "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": 3805.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3805.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4792.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3752.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4266.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3869.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "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": 1280.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3214.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3752.49
            },
            {
              "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": 5845,
              "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": 3805.1
            },
            {
              "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": 4792.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4728.61
            },
            {
              "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": 1595.69
            },
            {
              "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": 3752.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5845,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "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": 4792.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5845,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5845,
              "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": 3805.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4383.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "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": 4968.25
            },
            {
              "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": 3694.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "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": 3752.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4792.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3694.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3694.04
            },
            {
              "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": 3799.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5845,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "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": 3214.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3214.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4266.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3752.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4792.9
            },
            {
              "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": 3694.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3734.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "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": 3752.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5845,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4383.75
            },
            {
              "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": 5126.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4266.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3752.49
            },
            {
              "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": 5845,
              "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": 5126.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3752.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3805.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4968.25
            },
            {
              "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": 4266.85
            },
            {
              "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": 4968.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Colonoscopy Thru Stoma W Biopsy",
      "code_information": [
        {
          "code": "PX-75000067",
          "type": "CDM"
        },
        {
          "code": "44389",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5646,
          "discounted_cash": 3669.9,
          "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": 3624.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3105.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5646,
              "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": 1541.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3624.73
            },
            {
              "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": 1236.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4629.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3737.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "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": 3669.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "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": 4121.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4234.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3624.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4629.72
            },
            {
              "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": 4951.54
            },
            {
              "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": 5646,
              "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": 4951.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3105.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4629.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "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": 3568.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3568.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "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": 3105.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4121.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4121.58
            },
            {
              "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": 3568.27
            },
            {
              "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": 3624.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4121.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5646,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4680.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3105.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3105.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4680.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3737.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3624.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3675.55
            },
            {
              "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": 4629.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3105.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "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": 5646,
              "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": 4799.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3737.65
            },
            {
              "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": 4968.48
            },
            {
              "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": 4567.61
            },
            {
              "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": 3675.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5646,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4121.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3624.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4567.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4629.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3568.27
            },
            {
              "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": 4629.72
            },
            {
              "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": 4629.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5646,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3105.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4121.58
            },
            {
              "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": 4799.1
            },
            {
              "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": 5646,
              "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": 3624.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3675.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4234.5
            },
            {
              "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": 3624.73
            },
            {
              "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": 3624.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3675.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3568.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5646,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3624.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4629.72
            },
            {
              "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": 4799.1
            },
            {
              "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": 3675.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "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": 3568.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3568.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3737.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3624.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4680.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4234.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5646,
              "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": 3624.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3568.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3607.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4799.1
            },
            {
              "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": 5646,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Proctosigmoidoscopy Rigid",
      "code_information": [
        {
          "code": "PX-75000073",
          "type": "CDM"
        },
        {
          "code": "45300",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1031,
          "discounted_cash": 670.15,
          "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": 661.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 671.18
            },
            {
              "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": 567.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 651.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "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": 670.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1031,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 661.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 567.05
            },
            {
              "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": 854.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1031,
              "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": 876.35
            },
            {
              "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": 904.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1031,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1031,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 845.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1031
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 752.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 661.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 752.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1031,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 773.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 567.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 567.05
            },
            {
              "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": 752.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1031,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "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": 1031,
              "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": 671.18
            },
            {
              "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": 671.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 567.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 651.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1031,
              "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": 651.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "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": 1031,
              "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": 651.59
            },
            {
              "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": 281.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 651.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1031,
              "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": 661.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1031
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 661.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 671.18
            },
            {
              "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": 651.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 907.28
            },
            {
              "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": 834.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 752.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 671.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 567.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 752.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 773.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1031
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 651.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 661.9
            },
            {
              "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": 845.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 661.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 845.42
            },
            {
              "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": 904.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "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": 661.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 834.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 845.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 845.42
            },
            {
              "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": 845.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 661.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 1031
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 661.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 854.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 773.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 752.63
            },
            {
              "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": 651.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1031
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 854.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 567.05
            },
            {
              "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": 661.9
            },
            {
              "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": 661.9
            },
            {
              "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": 845.42
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 876.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 845.42
            }
          ]
        }
      ]
    },
    {
      "description": "HC Screen Can Colonoscopy High Risk",
      "code_information": [
        {
          "code": "PX-75000128",
          "type": "CDM"
        },
        {
          "code": "G0105",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4175,
          "discounted_cash": 2713.75,
          "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": 2680.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "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": 914.33
            },
            {
              "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": 3461.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4175,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2680.35
            },
            {
              "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": 2680.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3423.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2680.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2680.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3131.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2296.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3047.75
            },
            {
              "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": 4175,
              "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": 2680.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "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": 2713.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2680.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3047.75
            },
            {
              "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": 4175,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "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": 3674
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2680.35
            },
            {
              "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": 2680.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3423.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2296.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2296.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3047.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "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": 1139.78
            },
            {
              "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": 2638.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "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": 3423.5
            },
            {
              "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": 3548.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2638.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2680.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4175,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3377.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3423.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2638.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2296.25
            },
            {
              "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": 2638.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2763.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2763.85
            },
            {
              "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": 3423.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2717.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3131.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2296.25
            },
            {
              "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": 3047.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4175,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3047.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4175,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "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": 2680.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2638.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2763.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2717.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "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": 2296.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2296.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4175,
              "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": 3661.48
            },
            {
              "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": 4175,
              "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": 2717.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3461.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3377.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3047.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "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": 3661.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2763.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2680.35
            },
            {
              "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": 2717.93
            },
            {
              "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": 2717.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3423.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3548.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3423.5
            },
            {
              "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": 4175,
              "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": 2638.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2667.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4175,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3423.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3461.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3131.25
            },
            {
              "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": 2638.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2638.6
            },
            {
              "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": 3548.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Psychotherapy W Pt 30 Min",
      "code_information": [
        {
          "code": "PX-91400001",
          "type": "CDM"
        },
        {
          "code": "90832",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 279,
          "discounted_cash": 181.35,
          "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": 179.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 153.45
            },
            {
              "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": 279,
              "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": 279,
              "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": 237.15
            },
            {
              "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": 279,
              "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": 179.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 209.25
            },
            {
              "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": 228.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 237.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 154.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 231.29
            },
            {
              "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": 176.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 237.15
            },
            {
              "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": 176.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 153.45
            },
            {
              "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": 140.55,
              "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": 146.11,
              "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": 141.99,
              "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": 153.45
            },
            {
              "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": 154.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 209.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 237.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 153.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 225.71
            },
            {
              "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": 225.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 237.15
            },
            {
              "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": 181.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.67
            },
            {
              "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": 140.55,
              "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": 140.55,
              "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": 228.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 279,
              "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": 279,
              "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": 140.55,
              "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": 154.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 279
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 141.99,
              "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": 237.15
            },
            {
              "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": 179.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 181.63
            },
            {
              "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": 76.17
            },
            {
              "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": 279,
              "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": 153.45
            },
            {
              "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": 154.85
            },
            {
              "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": 139.15,
              "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": 203.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.78
            },
            {
              "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": 179.12
            },
            {
              "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": 181.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 237.15
            },
            {
              "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": 244.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 237.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.78
            },
            {
              "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": 228.78
            },
            {
              "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": 139.15,
              "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": 176.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 279,
              "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": 279,
              "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": 203.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 237.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 181.63
            },
            {
              "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": 181.63
            },
            {
              "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": 245.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 237.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 279,
              "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": 279,
              "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": 140.55,
              "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": 279,
              "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": 228.78
            },
            {
              "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": 179.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 179.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 179.12
            },
            {
              "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": 139.15,
              "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": 176.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 231.29
            },
            {
              "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": 231.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 176.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 176.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 209.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 153.45
            },
            {
              "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": 237.15
            },
            {
              "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": 237.15
            },
            {
              "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": 244.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 146.11,
              "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": 237.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 181.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 237.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 153.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.67
            },
            {
              "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": 141.99,
              "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": 279,
              "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": 203.67
            },
            {
              "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": 279,
              "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": 203.67
            },
            {
              "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": 179.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 176.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 176.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 279,
              "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": 279,
              "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": 179.12
            },
            {
              "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": 228.78
            },
            {
              "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": 139.15,
              "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": 146.11,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Psychotherapy W Pt 45 Min",
      "code_information": [
        {
          "code": "PX-91400003",
          "type": "CDM"
        },
        {
          "code": "90834",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 502,
          "discounted_cash": 326.3,
          "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": 322.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.8
            },
            {
              "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": 411.64
            },
            {
              "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": 426.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 278.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "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": 322.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 376.5
            },
            {
              "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": 136.21,
              "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": 276.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 140.55,
              "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": 317.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 326.3
            },
            {
              "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": 406.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "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": 136.21,
              "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": 276.1
            },
            {
              "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": 366.46
            },
            {
              "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": 140.55,
              "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": 426.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "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": 143.02,
              "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": 426.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 416.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 426.7
            },
            {
              "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": 322.28
            },
            {
              "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": 137.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 138.99,
              "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": 416.16
            },
            {
              "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": 146.11,
              "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": 440.25
            },
            {
              "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": 322.28
            },
            {
              "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": 140.55,
              "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": 416.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.1
            },
            {
              "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": 502,
              "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": 440.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 138.99,
              "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": 276.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 502,
              "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": 426.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 441.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 406.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 502
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 502,
              "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": 317.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 411.64
            },
            {
              "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": 317.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "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": 502,
              "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": 146.11,
              "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": 502,
              "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": 426.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "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": 326.8
            },
            {
              "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": 136.21,
              "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": 322.28
            },
            {
              "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": 278.61
            },
            {
              "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": 140.55,
              "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": 426.7
            },
            {
              "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": 411.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 426.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 136.21,
              "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": 366.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 426.7
            },
            {
              "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": 278.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 366.46
            },
            {
              "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": 502,
              "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": 426.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "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": 326.8
            },
            {
              "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": 278.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 138.99,
              "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": 502,
              "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": 276.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.26
            },
            {
              "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": 317.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.28
            },
            {
              "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": 411.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 376.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 426.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 276.1
            },
            {
              "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": 322.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 502,
              "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": 426.7
            },
            {
              "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": 140.55,
              "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": 376.5
            },
            {
              "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": 502,
              "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": 502,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Php Group Psychotherapy 45 to 50 Min",
      "code_information": [
        {
          "code": "PX-91500002",
          "type": "CDM"
        },
        {
          "code": "G0410",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 474,
          "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": 304.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 304.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 308.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 304.31
            },
            {
              "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": 304.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 263.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 474,
              "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": 304.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 304.31
            },
            {
              "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": 474,
              "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": 474,
              "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": 474
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 263.07
            },
            {
              "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": 263.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 474,
              "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": 308.57
            },
            {
              "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": 308.57
            },
            {
              "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": 383.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 474,
              "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": 304.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 304.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 474,
              "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": 304.31
            },
            {
              "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": 308.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 308.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 383.47
            },
            {
              "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": 304.31
            },
            {
              "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": 263.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 474,
              "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": 304.31
            },
            {
              "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": 304.31
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 474,
          "discounted_cash": 308.1,
          "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": 346.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 260.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "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": 299.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 388.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 299.57
            },
            {
              "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": 260.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 260.7
            },
            {
              "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": 474,
              "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": 402.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 299.57
            },
            {
              "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": 474,
              "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": 355.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 474,
              "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": 299.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 260.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 346.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 474,
              "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": 388.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 260.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 388.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 260.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 346.02
            },
            {
              "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": 402.9
            },
            {
              "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": 474,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 355.5
            },
            {
              "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": 474,
              "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": 346.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "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": 308.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 392.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 346.02
            },
            {
              "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": 129.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 299.57
            },
            {
              "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": 415.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 388.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 355.5
            },
            {
              "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": 402.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "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": 392.95
            },
            {
              "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": 415.7
            },
            {
              "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": 388.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 392.95
            },
            {
              "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": 299.57
            },
            {
              "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": 417.12
            },
            {
              "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": 388.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 346.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 299.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 388.68
            },
            {
              "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": 299.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 260.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 402.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 388.68
            }
          ]
        }
      ]
    },
    {
      "description": "HC Doppler Transcranial Complete",
      "code_information": [
        {
          "code": "PX-92100003",
          "type": "CDM"
        },
        {
          "code": "93886",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 887,
          "discounted_cash": 576.55,
          "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": 569.45
            },
            {
              "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": 717.58
            },
            {
              "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": 487.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 647.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 560.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 560.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 569.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 569.45
            },
            {
              "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": 647.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 569.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 560.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 560.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 665.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 577.44
            },
            {
              "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": 727.34
            },
            {
              "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": 727.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 487.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 887
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 753.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 717.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 780.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 487.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 487.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 735.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 753.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 569.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 753.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 735.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 887,
              "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": 647.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 753.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 647.51
            },
            {
              "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": 887,
              "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": 569.45
            },
            {
              "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": 569.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 569.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 753.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 753.95
            },
            {
              "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": 492.29
            },
            {
              "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": 735.32
            },
            {
              "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": 560.58
            },
            {
              "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": 560.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 887,
              "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": 577.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 727.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 753.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 753.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 727.34
            },
            {
              "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": 242.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 647.51
            },
            {
              "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": 727.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 727.34
            },
            {
              "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": 560.58
            },
            {
              "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": 777.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 492.29
            },
            {
              "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": 777.9
            },
            {
              "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": 492.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 727.34
            },
            {
              "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": 887,
              "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": 887,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 577.44
            },
            {
              "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": 577.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 492.29
            },
            {
              "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": 569.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 487.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 560.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 569.45
            },
            {
              "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": 577.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 487.85
            },
            {
              "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": 753.95
            },
            {
              "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": 887,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 753.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 647.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 576.55
            },
            {
              "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": 569.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 665.25
            },
            {
              "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": 887,
              "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": 569.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 753.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 887,
              "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": 487.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 727.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 665.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 753.95
            }
          ]
        }
      ]
    },
    {
      "description": "HC Noninvsve Physiolgc Studies Le Art W Stress",
      "code_information": [
        {
          "code": "PX-92100007",
          "type": "CDM"
        },
        {
          "code": "93924",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1364,
          "discounted_cash": 886.6,
          "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": 875.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 875.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1023
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1364,
              "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": 757.02
            },
            {
              "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": 887.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 995.72
            },
            {
              "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": 875.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1130.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 862.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 887.96
            },
            {
              "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": 862.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 298.72
            },
            {
              "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": 875.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 887.96
            },
            {
              "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": 1364,
              "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": 1364,
              "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": 1364,
              "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": 1118.48
            },
            {
              "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": 372.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 995.72
            },
            {
              "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": 276.69,
              "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": 287.2,
              "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": 862.05
            },
            {
              "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": 279.54,
              "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": 875.69
            },
            {
              "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": 875.69
            },
            {
              "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": 1159.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 995.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 862.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 875.69
            },
            {
              "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": 757.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1364,
              "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": 1159.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 750.2
            },
            {
              "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": 276.69,
              "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": 1118.48
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1364,
              "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": 886.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 1364,
              "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": 862.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "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": 995.72
            },
            {
              "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": 276.69,
              "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": 1130.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1364,
              "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": 279.54,
              "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": 875.69
            },
            {
              "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": 887.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1364
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 995.72
            },
            {
              "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": 1159.4
            },
            {
              "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": 301.56,
              "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": 875.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 875.69
            },
            {
              "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": 273.95,
              "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": 273.95,
              "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": 1196.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 862.05
            },
            {
              "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": 1200.32
            },
            {
              "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": 276.69,
              "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": 1364,
              "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": 279.54,
              "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": 757.02
            },
            {
              "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": 287.2,
              "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": 63.2,
              "estimated_amount": 862.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1159.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 750.2
            },
            {
              "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": 1196.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 995.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 875.69
            },
            {
              "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": 1118.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1118.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 1118.48
            },
            {
              "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": 1103.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "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": 276.69,
              "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": 875.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 887.96
            },
            {
              "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": 287.65,
              "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": 1103.48
            },
            {
              "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": 1364,
              "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": 862.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1364,
              "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": 757.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 750.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1130.76
            },
            {
              "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": 287.65,
              "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": 1023
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1023
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1159.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC Reducing or Dm Lc per Class",
      "code_information": [
        {
          "code": "PX-94200014",
          "type": "CDM"
        },
        {
          "code": "S9449",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29,
          "discounted_cash": 18.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "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": 15.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 29,
              "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": 21.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 29,
              "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": 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": 21.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 16.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 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": 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": 7.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 21.17
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 21.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 18.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 24.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "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": 25.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 25.43
            },
            {
              "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": 18.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.75
            },
            {
              "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": 25.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 21.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "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": 18.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 18.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 18.33
            },
            {
              "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": 29,
              "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": 18.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "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,
              "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,
              "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": 29,
              "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": 29,
              "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": 23.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 29,
              "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": 24.65
            },
            {
              "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,
              "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": 18.62
            },
            {
              "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": 18.62
            },
            {
              "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": 18.62
            },
            {
              "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": 16.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29,
              "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": 23.78
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "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": 18.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.62
            },
            {
              "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": 29,
              "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": 29,
              "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": 15.95
            },
            {
              "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": 29,
              "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": 16.1
            },
            {
              "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": 18.33
            },
            {
              "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": 29,
              "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": 24.65
            },
            {
              "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": 23.46
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.04
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fitness Consultation",
      "code_information": [
        {
          "code": "PX-94200030",
          "type": "CDM"
        },
        {
          "code": "S9451",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 90,
          "discounted_cash": 58.5,
          "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": 57.78
            },
            {
              "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": 57.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 49.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "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": 90,
              "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": 90,
              "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": 76.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "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": 65.7
            },
            {
              "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": 74.61
            },
            {
              "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": 76.5
            },
            {
              "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": 58.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 72.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 57.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 74.61
            },
            {
              "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": 78.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 90,
              "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": 90,
              "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": 57.78
            },
            {
              "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": 73.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.78
            },
            {
              "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": 76.5
            },
            {
              "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": 57.78
            },
            {
              "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": 24.57
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.5
            },
            {
              "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": 49.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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,
              "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": 67.5
            },
            {
              "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": 90,
              "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": 76.5
            },
            {
              "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": 78.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 56.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 58.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.78
            },
            {
              "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": 58.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "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": 79.2
            },
            {
              "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": 49.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 57.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.7
            },
            {
              "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": 56.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 76.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "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": 57.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "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,
              "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": 57.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "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": 90,
              "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": 58.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 57.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "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": 56.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 90,
              "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": 73.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90,
              "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": 76.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "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": 72.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 49.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "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": 74.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.88
            },
            {
              "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": 49.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 90
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.8
            },
            {
              "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": 73.8
            },
            {
              "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": 73.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 90,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter 100% Silicone 14 Fr 5 Cc Coude",
      "code_information": [
        {
          "code": "PX-CH-KN20514C",
          "type": "CDM"
        },
        {
          "code": "A4344",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29.49,
          "discounted_cash": 19.17,
          "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": 18.93
            },
            {
              "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": 23.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.18
            },
            {
              "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": 24.18
            },
            {
              "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": 25.86
            },
            {
              "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": 24.45
            },
            {
              "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": 29.49,
              "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": 25.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.49,
              "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": 16.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 29.49,
              "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": 18.93
            },
            {
              "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": 29.49,
              "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": 29.49,
              "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": 24.45
            },
            {
              "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": 19.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 21.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.2
            },
            {
              "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": 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": 29.49,
              "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": 18.64
            },
            {
              "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": 16.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 29.49,
              "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": 25.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 29.49,
              "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": 29.49,
              "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": 16.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.45
            },
            {
              "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": 18.64
            },
            {
              "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": 25.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.64
            },
            {
              "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": 25.86
            },
            {
              "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": 25.07
            },
            {
              "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": 8.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.07
            },
            {
              "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": 18.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 29.49,
              "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": 29.49,
              "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": 29.49,
              "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": 16.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 18.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 21.53
            },
            {
              "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": 29.49,
              "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": 16.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 25.07
            },
            {
              "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": 29.49,
              "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": 64.2,
              "estimated_amount": 18.93
            },
            {
              "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": 18.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.22
            },
            {
              "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": 21.53
            },
            {
              "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": 29.49,
              "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": 29.49,
              "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": 22.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 24.18
            },
            {
              "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": 16.22
            },
            {
              "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": 29.49,
              "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": 19.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.07
            },
            {
              "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": 29.49,
              "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": 25.07
            },
            {
              "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": 29.49,
              "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": 29.49,
              "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": 29.49,
              "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": 29.49,
              "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": 29.49
            },
            {
              "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": 18.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.93
            },
            {
              "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": 29.49,
              "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": 19.2
            },
            {
              "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": 29.49,
              "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": 29.49,
              "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": 18.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.86
            },
            {
              "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": 24.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.49,
              "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": 25.07
            },
            {
              "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": 18.64
            },
            {
              "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": 25.95
            },
            {
              "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": 29.49,
              "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": 29.49,
              "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": 18.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.07
            }
          ]
        }
      ]
    },
    {
      "description": "Alginate Calcium/Cmc Dressing 4 in X 4 in Reliamed",
      "code_information": [
        {
          "code": "PX-CH-ZCA4475RF",
          "type": "CDM"
        },
        {
          "code": "A6196",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.6,
          "discounted_cash": 2.34,
          "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": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "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": 3.6,
              "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": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 2.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "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": 3.6,
              "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": 2.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 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": 3.06
            },
            {
              "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": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 3.06
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 2.7
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 2.95
            },
            {
              "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": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 1.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "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": 2.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "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": 3.6,
              "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": 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": 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": 2.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 3.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "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": 3.06
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 2.31
            },
            {
              "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": 2.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "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": 2.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 2.31
            },
            {
              "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": 1.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 2.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "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": 2
            },
            {
              "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": 3.6,
              "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
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 3.06
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "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": 2.91
            },
            {
              "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": 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": 2.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 3.06
            },
            {
              "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": 2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 2.63
            },
            {
              "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": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 2.95
            },
            {
              "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": 3.6,
              "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": 2.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 3.06
            },
            {
              "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": 0.98
            },
            {
              "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": 2.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.06
            },
            {
              "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": 3.17
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 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": 2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 2.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 2.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 3.6,
              "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": 3.6,
              "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": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 2.31
            },
            {
              "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": 2.91
            },
            {
              "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": 3.6,
              "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": 2.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.91
            },
            {
              "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": 2.34
            },
            {
              "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": 2.28
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 2.63
            },
            {
              "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": 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": 2.98
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 3.06
            },
            {
              "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": 1.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 3.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "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": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 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": 3.6,
              "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": 3.06
            },
            {
              "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": 3.6,
              "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": 2.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.98
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 2.98
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 3.6,
              "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": 3.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "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": 3.6,
              "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": 2.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 1.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "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": 3.06
            },
            {
              "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": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.6,
              "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": 1.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 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": 2.95
            },
            {
              "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": 3.6,
              "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": 2.63
            },
            {
              "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": 3.6,
              "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": 3.6,
              "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": 2.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.31
            },
            {
              "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": 2.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "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": 2.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.6,
              "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": 3.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.7
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.98
            },
            {
              "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": 3.6,
              "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": 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": 2.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 2.95
            },
            {
              "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": 2.95
            }
          ]
        }
      ]
    },
    {
      "description": "Ide G160227 Optimize Svelte Coronary Stent System",
      "code_information": [
        {
          "code": "PX-62400190",
          "type": "CDM"
        },
        {
          "code": "C1874",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1,
          "discounted_cash": 0.65,
          "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": 0.64
            },
            {
              "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": 0.63
            },
            {
              "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": 1,
              "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": 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
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 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": 0.82
            },
            {
              "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": 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": 0.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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,
              "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": 0.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1,
              "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": 1,
              "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": 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": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 1,
              "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": 0.83
            },
            {
              "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": 1,
              "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": 0.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "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": 1,
              "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": 0.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "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,
              "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": 0.64
            },
            {
              "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": 0.27
            },
            {
              "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": 1,
              "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,
              "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": 0.85
            },
            {
              "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": 1,
              "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": 0.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 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": 0.85
            },
            {
              "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,
              "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": 1,
              "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": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "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": 1,
              "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,
              "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,
              "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": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 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": 0.64
            },
            {
              "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": 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,
              "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": 0.85
            },
            {
              "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": 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": 0.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "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": 1,
              "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": 0.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "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": 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": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1,
              "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,
              "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": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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,
              "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": 0.63
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1,
              "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": 0.64
            },
            {
              "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": 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,
              "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,
              "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": 0.85
            },
            {
              "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": 1,
              "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": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 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": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.85
            },
            {
              "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": 0.63
            },
            {
              "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": 0.56
            },
            {
              "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": 0.85
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1,
              "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": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.73
            },
            {
              "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": 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": 1,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ia Noninfect Agnt Qnt Ria Special So",
      "code_information": [
        {
          "code": "PX-30101307",
          "type": "CDM"
        },
        {
          "code": "83519",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2454,
          "discounted_cash": 1595.1,
          "minimum": 12.78,
          "maximum": 69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2454,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 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": 2085.9
            },
            {
              "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": 2012.28
            },
            {
              "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": 1791.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "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": 1791.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.74,
              "estimated_amount": 19.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1840.5
            },
            {
              "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": 1104.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 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": 1595.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2012.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1791.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1349.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1104.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "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": 2012.28
            },
            {
              "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": 613.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "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": 2085.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2012.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1104.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1349.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1791.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2012.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 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": 537.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1349.7
            },
            {
              "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": 1104.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 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": 2159.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "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": 1104.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1349.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.58,
              "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": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2012.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "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": 2454,
              "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": 1840.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1104.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2454
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1104.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1791.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1104.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.4,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.32,
              "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": 2085.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1349.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1791.42
            },
            {
              "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": 2454,
              "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": 45,
              "estimated_amount": 1104.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1349.7
            },
            {
              "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": 1349.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 18.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.78,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 69,
              "estimated_amount": 69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.74,
              "estimated_amount": 19.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2012.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1227
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2085.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.18,
              "estimated_amount": 13.18
            },
            {
              "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": 2012.28
            },
            {
              "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": 1227
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1840.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1104.3
            }
          ]
        }
      ]
    },
    {
      "description": "Mask Particulate Respirator Type N95",
      "code_information": [
        {
          "code": "PX-CH-3M1860",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.16,
          "discounted_cash": 0.75,
          "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": 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": 1.16,
              "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": 1.16,
              "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": 0.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 0.74
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.74
            },
            {
              "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": 1.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "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": 0.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 1.16,
              "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": 1.16,
              "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": 0.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.64
            },
            {
              "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": 0.99
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.16,
              "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": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 1.16,
              "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": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.95
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 1.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "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": 1.16,
              "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": 0.74
            },
            {
              "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": 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": 0.73
            },
            {
              "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": 0.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "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": 1.16,
              "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": 0.94
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.64
            },
            {
              "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": 1.16,
              "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": 1.16,
              "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": 0.99
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "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": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.85
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.85
            },
            {
              "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": 1.16,
              "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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.64
            },
            {
              "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": 0.95
            },
            {
              "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": 0.76
            }
          ]
        }
      ]
    },
    {
      "description": "HC Grafix Prime 2 X 3 per Sq Cm",
      "code_information": [
        {
          "code": "PX-63600046",
          "type": "CDM"
        },
        {
          "code": "Q4133",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 559,
          "discounted_cash": 363.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.88
            },
            {
              "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": 363.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.07
            },
            {
              "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": 559,
              "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": 475.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 353.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.88
            },
            {
              "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": 463.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 458.38
            },
            {
              "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": 559,
              "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": 363.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 458.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 559,
              "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": 353.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 458.38
            },
            {
              "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": 458.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 475.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 307.45
            },
            {
              "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": 408.07
            },
            {
              "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": 559,
              "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": 419.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.88
            },
            {
              "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": 358.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 463.41
            },
            {
              "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": 353.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 559,
              "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": 559,
              "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": 559,
              "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": 358.88
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 559,
              "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": 475.15
            },
            {
              "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": 559,
              "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": 559,
              "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": 490.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 363.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 310.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.88
            },
            {
              "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": 452.23
            },
            {
              "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": 152.61
            },
            {
              "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": 353.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 475.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 353.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 307.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 475.15
            },
            {
              "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": 310.25
            },
            {
              "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": 475.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 458.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.07
            },
            {
              "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": 559,
              "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": 358.88
            },
            {
              "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": 310.25
            },
            {
              "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": 490.24
            },
            {
              "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": 559,
              "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": 452.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 559,
              "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": 559,
              "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": 559,
              "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": 559,
              "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": 307.45
            },
            {
              "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": 363.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 458.38
            },
            {
              "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": 559,
              "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": 419.25
            },
            {
              "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": 559,
              "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": 475.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 559,
              "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": 559,
              "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": 307.45
            },
            {
              "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": 307.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 475.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 475.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 307.45
            },
            {
              "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": 559,
              "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": 310.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 353.29
            },
            {
              "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": 559,
              "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": 475.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 307.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.07
            },
            {
              "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": 353.29
            },
            {
              "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": 458.38
            },
            {
              "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": 458.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 475.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 353.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 475.15
            },
            {
              "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": 559,
              "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": 491.92
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 559,
              "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": 358.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 363.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 358.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 559,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 559
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 463.41
            },
            {
              "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": 358.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 475.15
            },
            {
              "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": 358.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 559,
              "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": 559,
              "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": 559,
              "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": 559,
              "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": 363.35
            },
            {
              "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": 475.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 419.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sleeve Scd Level 1 X Small and Small",
      "code_information": [
        {
          "code": "PX-27100036",
          "type": "CDM"
        },
        {
          "code": "27100036",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39,
          "discounted_cash": 25.35,
          "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": 25.04
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.31
            },
            {
              "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": 24.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "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": 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": 25.04
            },
            {
              "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": 33.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.31
            },
            {
              "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": 25.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "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": 21.45
            },
            {
              "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": 25.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "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": 25.04
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "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": 34.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "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": 24.49
            },
            {
              "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": 21.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 24.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 21.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "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": 39,
              "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": 25.04
            },
            {
              "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": 10.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "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": 25.04
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.33
            },
            {
              "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": 34.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 28.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "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": 39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 32.33
            },
            {
              "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": 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": 21.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "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": 25.35
            },
            {
              "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": 25.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "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": 21.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "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": 34.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "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": 39,
              "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": 33.15
            },
            {
              "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": 31.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39,
              "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": 24.65
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 28.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "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": 24.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.65
            },
            {
              "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": 25.39
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ot Therapeutic Massage 15 Min",
      "code_information": [
        {
          "code": "PX-43000024",
          "type": "CDM"
        },
        {
          "code": "97124",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 122,
          "discounted_cash": 79.3,
          "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": 78.32
            },
            {
              "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": 79.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "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": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 103.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "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": 67.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "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": 28.67
            },
            {
              "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": 30.1
            },
            {
              "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": 103.7
            },
            {
              "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": 77.1
            },
            {
              "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": 122,
              "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": 78.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 67.71
            },
            {
              "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": 28.67
            },
            {
              "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": 28.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 79.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 101.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "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": 100.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 28.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.71
            },
            {
              "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": 67.71
            },
            {
              "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": 28.67
            },
            {
              "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": 122,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 25.69
            },
            {
              "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": 100.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "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": 79.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "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": 28.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "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": 122,
              "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": 106.99
            },
            {
              "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": 28.67
            },
            {
              "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": 98.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 107.36
            },
            {
              "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": 78.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "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": 28.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "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": 78.32
            },
            {
              "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": 78.32
            },
            {
              "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": 28.67
            },
            {
              "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": 28.67
            },
            {
              "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": 122,
              "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": 106.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "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": 28.67
            },
            {
              "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": 122,
              "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": 79.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 77.1
            },
            {
              "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": 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": 78.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 122,
              "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": 78.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "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": 101.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 77.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 98.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 122,
              "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": 89.06
            },
            {
              "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": 28.67
            },
            {
              "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": 67.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 103.7
            },
            {
              "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": 33.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.5
            },
            {
              "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": 100.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 101.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 91.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ot Group Exercise",
      "code_information": [
        {
          "code": "PX-43000026",
          "type": "CDM"
        },
        {
          "code": "97150",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 132,
          "discounted_cash": 85.8,
          "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": 84.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "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": 115.76
            },
            {
              "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": 84.74
            },
            {
              "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": 84.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 73.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "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": 73.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 132,
              "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": 17.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.43
            },
            {
              "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": 115.76
            },
            {
              "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": 116.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 106.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "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": 17.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 132,
              "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": 112.2
            },
            {
              "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": 17.28
            },
            {
              "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": 132,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 17.28
            },
            {
              "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": 84.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.74
            },
            {
              "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": 17.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "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": 17.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 132,
              "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": 132,
              "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": 96.36
            },
            {
              "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": 17.28
            },
            {
              "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": 73.26
            },
            {
              "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": 132,
              "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": 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": 84.74
            },
            {
              "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": 85.93
            },
            {
              "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": 108.24
            },
            {
              "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": 108.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 132,
              "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": 108.24
            },
            {
              "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": 83.42
            },
            {
              "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": 132,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 17.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.43
            },
            {
              "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": 72.6
            },
            {
              "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": 17.28
            },
            {
              "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": 106.79
            },
            {
              "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": 85.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 18.14
            },
            {
              "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": 112.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "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": 96.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 132
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.43
            },
            {
              "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": 17.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.42
            },
            {
              "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": 132,
              "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": 73.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.93
            },
            {
              "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": 108.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "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": 112.2
            },
            {
              "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": 132,
              "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": 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": 83.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "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": 36.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 83.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 96.36
            },
            {
              "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": 17.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "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": 17.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 17.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.36
            },
            {
              "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": 17.28
            },
            {
              "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": 85.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "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": 132,
              "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": 112.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 132,
              "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": 132,
              "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": 132,
              "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": 112.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "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": 112.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.36
            },
            {
              "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": 84.74
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cannula Axillary Aortic",
      "code_information": [
        {
          "code": "PX-27200378",
          "type": "CDM"
        },
        {
          "code": "27200378",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 146,
          "discounted_cash": 94.9,
          "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": 93.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 118.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "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": 146,
              "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": 92.27
            },
            {
              "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": 93.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 109.5
            },
            {
              "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": 92.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 94.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 94.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.73
            },
            {
              "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": 95.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 106.58
            },
            {
              "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": 128.04
            },
            {
              "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": 128.04
            },
            {
              "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": 94.9
            },
            {
              "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": 121.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 109.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 106.58
            },
            {
              "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": 146,
              "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": 93.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "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": 118.11
            },
            {
              "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": 119.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 119.72
            },
            {
              "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": 91.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 106.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 146,
              "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": 146,
              "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": 119.72
            },
            {
              "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": 93.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.73
            },
            {
              "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": 92.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.03
            },
            {
              "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": 106.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 94.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "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": 93.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 146
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 94.75
            },
            {
              "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": 81.03
            },
            {
              "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": 93.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 119.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 106.58
            },
            {
              "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": 91.69
            },
            {
              "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": 91.69
            },
            {
              "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": 80.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 119.72
            },
            {
              "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": 95.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "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": 92.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 146,
              "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": 93.73
            },
            {
              "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": 93.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 81.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 106.58
            },
            {
              "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": 128.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "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": 119.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.05
            },
            {
              "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": 39.86
            },
            {
              "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": 81.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 119.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 109.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 119.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 91.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.3
            },
            {
              "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": 124.1
            },
            {
              "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": 124.1
            },
            {
              "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": 81.03
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pt Eval Epv",
      "code_information": [
        {
          "code": "PX-42000126",
          "type": "CDM"
        },
        {
          "code": "42000126",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 166,
          "discounted_cash": 107.9,
          "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": 106.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 136.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 107.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 107.73
            },
            {
              "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": 92.13
            },
            {
              "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": 108.07
            },
            {
              "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": 45.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 91.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 121.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 106.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 106.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "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": 137.61
            },
            {
              "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": 141.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 166,
              "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": 104.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 136.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 136.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 91.3
            },
            {
              "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": 106.57
            },
            {
              "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": 104.91
            },
            {
              "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": 104.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "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": 104.25
            },
            {
              "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": 134.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 91.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 91.3
            },
            {
              "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": 121.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 107.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 92.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 121.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "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": 92.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 91.3
            },
            {
              "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": 106.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "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": 104.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 136.12
            },
            {
              "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": 136.12
            },
            {
              "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": 166,
              "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": 141.1
            },
            {
              "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": 136.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 136.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 106.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 106.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "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": 104.25
            },
            {
              "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": 92.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 166
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 145.58
            },
            {
              "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": 104.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 106.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 108.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 124.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 166,
              "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": 121.18
            },
            {
              "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": 145.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 124.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 108.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 136.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 91.3
            },
            {
              "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": 141.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 137.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 137.61
            },
            {
              "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": 166,
              "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": 106.57
            },
            {
              "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": 106.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "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": 91.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 121.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "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": 146.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 106.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 108.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 121.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 104.25
            },
            {
              "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": 107.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 124.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 141.1
            },
            {
              "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": 166,
              "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": 106.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 134.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 107.73
            },
            {
              "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": 108.07
            }
          ]
        }
      ]
    },
    {
      "description": "HC Heart Valve 3",
      "code_information": [
        {
          "code": "PX-27800149",
          "type": "CDM"
        },
        {
          "code": "27800149",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2578,
          "discounted_cash": 1675.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "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": 1688.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "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": 2578,
              "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": 1572.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2578
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2260.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1881.94
            },
            {
              "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": 2578,
              "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": 2578,
              "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": 2191.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "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": 2113.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2113.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1881.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1647.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "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": 1881.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1678.28
            },
            {
              "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": 1688.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1688.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2113.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1417.9
            },
            {
              "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": 703.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1417.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1688.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "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": 1652.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "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": 1678.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2137.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1647.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1881.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1678.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1688.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "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": 2191.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2113.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2113.96
            },
            {
              "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": 2085.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1647.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1417.9
            },
            {
              "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": 1572.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "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": 2191.3
            },
            {
              "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": 1652.5
            },
            {
              "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": 1417.9
            },
            {
              "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": 2268.64
            },
            {
              "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": 1652.5
            },
            {
              "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": 1430.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2085.6
            },
            {
              "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": 2113.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "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": 1688.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1688.59
            },
            {
              "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": 1675.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1417.9
            },
            {
              "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": 1430.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1933.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1881.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "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": 1652.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1678.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1572.58
            },
            {
              "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": 1430.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1430.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1933.5
            },
            {
              "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": 2578,
              "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": 2260.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1647.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1688.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1417.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2137.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2578,
              "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": 1417.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1881.94
            },
            {
              "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": 2137.16
            },
            {
              "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": 2113.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2113.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1933.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1652.5
            },
            {
              "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": 1678.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2191.3
            }
          ]
        }
      ]
    },
    {
      "description": "HC Heart Valve 16",
      "code_information": [
        {
          "code": "PX-27800162",
          "type": "CDM"
        },
        {
          "code": "27800162",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15475,
          "discounted_cash": 10058.75,
          "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": 9919.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12519.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11296.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12828.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10136.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10074.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10074.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10136.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "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": 8588.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11606.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10074.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11296.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 9919.48
            },
            {
              "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": 10136.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10136.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "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": 9919.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8511.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11296.75
            },
            {
              "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": 12689.5
            },
            {
              "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": 15475,
              "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": 9919.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15475
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11606.25
            },
            {
              "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": 12689.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8511.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 9888.53
            },
            {
              "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": 10074.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12689.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "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": 11296.75
            },
            {
              "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": 13153.75
            },
            {
              "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": 15475,
              "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": 12828.78
            },
            {
              "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": 8511.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11296.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 9888.53
            },
            {
              "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": 13571.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "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": 10136.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "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": 10136.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8511.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 9919.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12689.5
            },
            {
              "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": 4224.68
            },
            {
              "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": 9919.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12689.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15475,
              "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": 9919.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10136.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 9888.53
            },
            {
              "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": 13153.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "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": 13618
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 9919.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 9919.48
            },
            {
              "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": 12519.28
            },
            {
              "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": 10058.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11296.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10136.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "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": 10074.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8511.25
            },
            {
              "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": 15475,
              "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": 8588.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "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": 9919.48
            },
            {
              "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": 12689.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8588.63
            },
            {
              "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": 8588.63
            },
            {
              "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": 12828.78
            },
            {
              "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": 13571.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "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": 9439.75
            },
            {
              "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": 9919.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12689.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8511.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8511.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 9919.48
            },
            {
              "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": 15475,
              "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": 13153.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9439.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 9888.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12689.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13153.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11606.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Heart Valve 23",
      "code_information": [
        {
          "code": "PX-27800169",
          "type": "CDM"
        },
        {
          "code": "27800169",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 24501,
          "discounted_cash": 15925.65,
          "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": 15705.14
            },
            {
              "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": 14945.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13475.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13475.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20090.82
            },
            {
              "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": 20825.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "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": 13475.55
            },
            {
              "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": 15705.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15950.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "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": 24501,
              "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": 15705.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18375.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17885.73
            },
            {
              "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": 24501,
              "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": 20090.82
            },
            {
              "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": 6688.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13475.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17885.73
            },
            {
              "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": 20090.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20090.82
            },
            {
              "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": 16048.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 16048.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18375.75
            },
            {
              "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": 17885.73
            },
            {
              "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": 21487.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13475.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13475.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17885.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20311.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20311.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 16048.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19821.31
            },
            {
              "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": 19821.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13475.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 15656.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 15656.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 15656.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "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": 20311.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20090.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 24501
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 15656.14
            },
            {
              "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": 15950.15
            },
            {
              "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": 20090.82
            },
            {
              "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": 16048.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 15705.14
            },
            {
              "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": 15705.14
            },
            {
              "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": 24501,
              "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": 15925.65
            },
            {
              "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": 20090.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "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": 24501,
              "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": 16048.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 16048.16
            },
            {
              "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": 16048.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 15705.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 15705.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15950.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18375.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 15705.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "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": 20825.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 15705.14
            },
            {
              "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": 21487.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 16048.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17885.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17885.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "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": 15705.14
            },
            {
              "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": 13598.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 15705.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13598.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15950.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24501,
              "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": 21560.88
            },
            {
              "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": 13598.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 15705.14
            },
            {
              "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": 15950.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 14945.61
            },
            {
              "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": 13598.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20090.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20825.85
            }
          ]
        }
      ]
    },
    {
      "description": "Allergen Specific Igg Ea Allergen Sendout",
      "code_information": [
        {
          "code": "PX-30200566",
          "type": "CDM"
        },
        {
          "code": "86001",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 178,
          "discounted_cash": 115.7,
          "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": 114.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "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": 178,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.82,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 144
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.88
            },
            {
              "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": 178,
              "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": 147.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 133.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.5
            },
            {
              "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": 114.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 114.28
            },
            {
              "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": 48.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 114.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.82,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 133.5
            },
            {
              "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": 145.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.21,
              "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": 151.3
            },
            {
              "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": 151.3
            },
            {
              "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": 178,
              "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": 145.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 133.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 98.79
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.63,
              "estimated_amount": 7.63
            },
            {
              "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": 114.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 114.28
            },
            {
              "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": 145.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.82,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "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": 112.5
            },
            {
              "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": 112.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "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": 115.7
            },
            {
              "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": 156.64
            },
            {
              "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": 114.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.96
            },
            {
              "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": 115.88
            },
            {
              "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": 98.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 147.56
            },
            {
              "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": 112.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.88
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.82,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "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": 151.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 178
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.63,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "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": 97.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 114.28
            },
            {
              "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": 115.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 112.5
            },
            {
              "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": 156.11
            },
            {
              "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": 98.79
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.21,
              "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": 7.82,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "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": 98.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 147.56
            },
            {
              "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": 114.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.63,
              "estimated_amount": 7.63
            },
            {
              "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": 156.11
            },
            {
              "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": 112.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 114.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.82,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 114.28
            },
            {
              "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": 144
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 7.82,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.9,
              "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": 145.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 151.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.33,
              "estimated_amount": 29.33
            },
            {
              "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": 129.94
            },
            {
              "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": 114.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.82,
              "estimated_amount": 7.82
            }
          ],
          "minimum": 7.63,
          "maximum": 29.33
        }
      ]
    },
    {
      "description": "HC M Tuberculosis Amplified Probe",
      "code_information": [
        {
          "code": "PX-30600276",
          "type": "CDM"
        },
        {
          "code": "87556",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 543,
          "discounted_cash": 352.95,
          "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": 348.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.68,
              "estimated_amount": 41.68
            },
            {
              "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": 445.26
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 43.76,
              "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": 461.55
            },
            {
              "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": 476.21
            },
            {
              "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": 343.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 353.49
            },
            {
              "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": 445.26
            },
            {
              "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": 352.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.68,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "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": 450.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "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": 543,
              "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": 461.55
            },
            {
              "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": 353.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 543
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "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": 298.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 407.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.95,
              "estimated_amount": 49.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "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": 445.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 450.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 42.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.68,
              "estimated_amount": 41.68
            },
            {
              "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": 439.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "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": 343.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "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": 543,
              "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": 348.61
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.68,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 42.1,
              "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": 343.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 439.29
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.68,
              "estimated_amount": 41.68
            },
            {
              "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": 301.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "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": 396.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 42.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.68,
              "estimated_amount": 41.68
            },
            {
              "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": 301.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 353.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 353.49
            },
            {
              "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": 148.24
            },
            {
              "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": 476.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 407.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 407.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "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": 461.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "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": 343.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "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": 348.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "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": 477.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "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": 461.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "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": 543,
              "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": 343.18
            },
            {
              "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": 353.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.68,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 43.76,
              "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": 348.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 43.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 156.3,
              "estimated_amount": 156.3
            },
            {
              "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": 348.61
            },
            {
              "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": 348.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.95,
              "estimated_amount": 49.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 42.1,
              "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": 461.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.95,
              "estimated_amount": 49.95
            },
            {
              "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": 301.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 301.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 41.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 42.1,
              "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": 348.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 450.15
            }
          ],
          "minimum": 41.68,
          "maximum": 156.3
        }
      ]
    },
    {
      "description": "HC Vasc Embolize Occlude Bleed",
      "code_information": [
        {
          "code": "PX-36100750",
          "type": "CDM"
        },
        {
          "code": "37244",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 30688,
          "discounted_cash": 19947.2,
          "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": 19701.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19977.89
            },
            {
              "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": 30688,
              "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": 19394.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16878.4
            },
            {
              "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": 22402.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26084.8
            },
            {
              "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": 26913.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 26084.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22402.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19394.82
            },
            {
              "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": 19701.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 30688,
              "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": 19701.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26084.8
            },
            {
              "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": 25440.35
            },
            {
              "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": 26084.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25164.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23016
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19394.82
            },
            {
              "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": 27005.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25164.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16878.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26084.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16878.4
            },
            {
              "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": 30688,
              "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": 30688,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22402.24
            },
            {
              "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": 19977.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25164.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23016
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26084.8
            },
            {
              "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": 25164.16
            },
            {
              "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": 19394.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 30688,
              "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": 19947.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25440.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19701.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19394.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23016
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26084.8
            },
            {
              "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": 19701.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25164.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 30688,
              "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": 26084.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16878.4
            },
            {
              "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": 16878.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24826.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22402.24
            },
            {
              "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": 30688,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19394.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 24826.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19977.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 26084.8
            },
            {
              "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": 26913.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 30688,
              "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": 30688,
              "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": 22402.24
            },
            {
              "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": 25164.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 30688,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16878.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16878.4
            },
            {
              "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": 26084.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19701.7
            },
            {
              "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": 19977.89
            },
            {
              "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": 25164.16
            },
            {
              "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": 8377.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26084.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 19701.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19701.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19977.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19701.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26084.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19394.82
            },
            {
              "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": 30688,
              "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": 19701.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25164.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 30688,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30688,
              "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": 22402.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25440.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19701.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19394.82
            },
            {
              "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": 19701.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC St Behvrl and Qual Analysis of Voice",
      "code_information": [
        {
          "code": "PX-44400017",
          "type": "CDM"
        },
        {
          "code": "92524",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 176,
          "discounted_cash": 114.4,
          "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": 112.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "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": 111.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 149.6
            },
            {
              "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": 111.03
            },
            {
              "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": 144.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 132
            },
            {
              "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": 105.74
            },
            {
              "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": 176,
              "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": 154.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 105.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 176,
              "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": 176,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "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": 105.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "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": 97.68
            },
            {
              "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": 112.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 176,
              "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": 112.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 97.68
            },
            {
              "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": 112.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 142.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "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": 97.68
            },
            {
              "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": 114.58
            },
            {
              "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": 48.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 176,
              "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": 114.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 97.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 144.32
            },
            {
              "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": 105.74
            },
            {
              "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": 111.23
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 176,
              "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": 154.88
            },
            {
              "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": 105.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "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": 111.23
            },
            {
              "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": 145.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 114.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "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": 105.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "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": 88.18
            },
            {
              "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": 105.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.99
            },
            {
              "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": 144.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 149.6
            },
            {
              "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": 112.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 128.48
            },
            {
              "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": 105.74
            },
            {
              "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": 105.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 176,
              "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": 112.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 114.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "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": 154.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 149.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.8
            },
            {
              "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": 149.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.23
            },
            {
              "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": 142.38
            },
            {
              "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": 105.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 176,
              "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": 176,
              "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": 105.74
            },
            {
              "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": 105.74
            },
            {
              "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": 128.48
            },
            {
              "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": 176,
              "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": 96.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 114.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 176
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            },
            {
              "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": 105.74
            },
            {
              "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": 176,
              "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": 114.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 176,
              "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": 96.8
            },
            {
              "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": 144.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 149.6
            }
          ]
        }
      ]
    },
    {
      "description": "Tenotomy Perc Thigh Tendon/Adctr/Hamstrng Mult",
      "code_information": [
        {
          "code": "PX-51000076",
          "type": "CDM"
        },
        {
          "code": "27307",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5303,
          "discounted_cash": 3446.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3404.53
            },
            {
              "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": 2943.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2943.17
            },
            {
              "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": 3452.25
            },
            {
              "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": 4348.46
            },
            {
              "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": 2966.32,
              "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": 2825.06,
              "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": 4650.73
            },
            {
              "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": 3351.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 5303,
              "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": 4290.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3871.19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853.31,
              "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": 63.2,
              "estimated_amount": 3351.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3351.5
            },
            {
              "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": 2853.31,
              "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": 3977.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 2882.72,
              "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": 4507.55
            },
            {
              "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": 5303,
              "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": 4507.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "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": 4348.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3977.25
            },
            {
              "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": 2825.06,
              "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": 4348.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4348.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3351.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 4396.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 5303,
              "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": 2853.31,
              "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": 2943.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5303
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 3404.53
            },
            {
              "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": 3404.53
            },
            {
              "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": 3404.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2916.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 3404.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3404.53
            },
            {
              "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": 2825.06,
              "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": 2882.72,
              "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": 2916.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3404.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2916.65
            },
            {
              "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": 4348.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3452.25
            },
            {
              "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": 1447.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 1161.36
            },
            {
              "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": 3871.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3351.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3871.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3977.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3404.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 5303,
              "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": 2916.65
            },
            {
              "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": 2966.32,
              "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": 3404.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4348.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3871.19
            },
            {
              "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": 4396.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3404.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 4666.64
            },
            {
              "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": 3452.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4348.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 2916.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2916.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "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": 2943.17
            },
            {
              "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": 5303,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3404.53
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2825.06,
              "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": 5303,
              "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": 3452.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 2853.31,
              "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": 2853.31,
              "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": 2966.32,
              "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": 5303,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4650.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5303,
              "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": 5303,
              "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": 2882.72,
              "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": 4507.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2916.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3871.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "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": 4507.55
            },
            {
              "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": 3351.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4507.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4396.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3871.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3452.25
            },
            {
              "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": 4290.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3351.5
            },
            {
              "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": 3446.95
            },
            {
              "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": 3351.5
            },
            {
              "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": 5303,
              "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": 3404.53
            },
            {
              "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": 4507.55
            },
            {
              "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": 5303,
              "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": 4348.46
            }
          ]
        }
      ]
    },
    {
      "description": "25-Hydroxyvitamin D2 and D3 Sendout",
      "code_information": [
        {
          "code": "PX-30100955",
          "type": "CDM"
        },
        {
          "code": "82306",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 25,
          "discounted_cash": 16.25,
          "minimum": 29.15,
          "maximum": 111,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.9,
              "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": 45,
              "estimated_amount": 11.25
            },
            {
              "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": 11.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.25,
              "estimated_amount": 43.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "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": 25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.15,
              "estimated_amount": 25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.9,
              "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": 18.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 20.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.6,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "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": 12.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.6,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.25,
              "estimated_amount": 43.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_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
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.15,
              "estimated_amount": 25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.6,
              "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": 20.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.08,
              "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": 20.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "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": 20.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.6,
              "estimated_amount": 29.6
            },
            {
              "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": 12.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "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": 11.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.15,
              "estimated_amount": 25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.9,
              "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": 13.75
            },
            {
              "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": 21.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.6,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.6,
              "estimated_amount": 29.6
            },
            {
              "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": 21.25
            },
            {
              "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": 25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.15,
              "estimated_amount": 25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 29.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.6,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "UHC 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "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": 11.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.52,
              "estimated_amount": 65.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.25,
              "estimated_amount": 43.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 111,
              "estimated_amount": 111
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.83
            },
            {
              "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": 16.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Calcium Ionized Amb",
      "code_information": [
        {
          "code": "PX-30100956",
          "type": "CDM"
        },
        {
          "code": "82330",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 69,
          "discounted_cash": 44.85,
          "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": 44.3
            },
            {
              "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": 44.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "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": 60.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.36,
              "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": 51.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.96,
              "estimated_amount": 19.96
            },
            {
              "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": 55.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "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": 69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.96,
              "estimated_amount": 19.96
            },
            {
              "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": 44.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.58
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.36,
              "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": 58.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "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": 58.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.37
            },
            {
              "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": 44.3
            },
            {
              "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": 56.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.82,
              "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": 58.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.68,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.68,
              "estimated_amount": 13.68
            },
            {
              "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": 69,
              "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": 43.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.82
            },
            {
              "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": 56.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.58
            },
            {
              "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": 44.3
            },
            {
              "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": 38.3
            },
            {
              "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": 43.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.68,
              "estimated_amount": 13.68
            },
            {
              "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": 69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.82,
              "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": 44.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.92
            },
            {
              "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": 60.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.36,
              "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": 58.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.3
            },
            {
              "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": 44.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.82,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.68,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "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": 44.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.3
            },
            {
              "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": 38.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.82,
              "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": 38.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.96,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "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": 44.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.68,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.82,
              "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": 60.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "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": 56.58
            },
            {
              "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": 57.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.75
            },
            {
              "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": 43.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.92
            },
            {
              "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": 18.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.65
            },
            {
              "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": 43.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.68,
              "estimated_amount": 13.68
            },
            {
              "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": 37.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "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": 44.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.68,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.3,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.68,
              "estimated_amount": 13.68
            },
            {
              "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": 50.37
            }
          ],
          "minimum": 13.68,
          "maximum": 51.3
        }
      ]
    },
    {
      "description": "HC Pt Inr Amb",
      "code_information": [
        {
          "code": "PX-30500120",
          "type": "CDM"
        },
        {
          "code": "85610",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 36,
          "discounted_cash": 23.4,
          "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": 23.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.29,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.33,
              "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": 22.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.33,
              "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": 22.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.28
            },
            {
              "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": 26.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.11
            },
            {
              "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": 29.52
            },
            {
              "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": 31.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.74,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.29,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "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": 19.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.11
            },
            {
              "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": 31.57
            },
            {
              "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": 23.4
            },
            {
              "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": 36,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.33,
              "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": 30.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.5,
              "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": 4.29,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.74,
              "estimated_amount": 5.74
            },
            {
              "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": 19.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.44
            },
            {
              "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": 36,
              "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": 29.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "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": 30.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "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": 23.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.8
            },
            {
              "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": 9.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "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": 23.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "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": 22.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.29,
              "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": 27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.33,
              "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": 23.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.52
            },
            {
              "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": 19.98
            },
            {
              "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": 29.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.29,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.52
            },
            {
              "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": 22.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.5,
              "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": 23.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.29,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "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": 31.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.29,
              "estimated_amount": 4.29
            },
            {
              "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": 19.98
            },
            {
              "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": 22.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.28
            },
            {
              "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": 23.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 29.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.8
            },
            {
              "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": 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,
              "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": 29.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.74,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.29,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.33,
              "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": 29.12
            },
            {
              "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": 29.12
            },
            {
              "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": 30.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.09,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.6
            }
          ],
          "minimum": 4.29,
          "maximum": 16.09
        }
      ]
    },
    {
      "description": "Tgsap Sol Org/ Hematolymphoid Neo/Do 51+ Genes Dna or Combo Sendout",
      "code_information": [
        {
          "code": "PX-30101312",
          "type": "CDM"
        },
        {
          "code": "81455",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10530,
          "discounted_cash": 6844.5,
          "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": 6760.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6760.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8634.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7897.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6654.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6760.26
            },
            {
              "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": 7686.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 566.8,
              "estimated_amount": 566.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10530
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5791.5
            },
            {
              "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": 6855.03
            },
            {
              "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": 2874.69
            },
            {
              "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": 5844.15
            },
            {
              "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": 5844.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5791.5
            },
            {
              "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": 5791.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6855.03
            },
            {
              "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": 8634.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "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": 10530,
              "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": 6760.26
            },
            {
              "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": 6760.26
            },
            {
              "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": 8518.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7897.5
            },
            {
              "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": 6760.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6760.26
            },
            {
              "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": 10530,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6760.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "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": 6654.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7686.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5791.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7686.9
            },
            {
              "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": 5844.15
            },
            {
              "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": 8729.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6654.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7897.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "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": 10530,
              "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": 6654.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8518.77
            },
            {
              "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": 6760.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "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": 9234.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "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": 6855.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8634.6
            },
            {
              "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": 8634.6
            },
            {
              "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": 6760.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8729.37
            },
            {
              "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": 6654.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7686.9
            },
            {
              "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": 8950.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8729.37
            },
            {
              "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": 9234.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6760.26
            },
            {
              "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": 8634.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8634.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6654.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 566.8,
              "estimated_amount": 566.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8634.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5791.5
            },
            {
              "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": 8950.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5844.15
            },
            {
              "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": 9266.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7686.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7686.9
            },
            {
              "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": 6844.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6855.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8634.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8950.5
            },
            {
              "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": 6654.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5791.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6855.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6654.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6760.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10948.5,
              "estimated_amount": 10948.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5791.5
            }
          ],
          "minimum": 566.8,
          "maximum": 10948.5
        }
      ]
    },
    {
      "description": "Heparin Flush Sterile 100uml 5ml (10ml Syringe)",
      "code_information": [
        {
          "code": "PX-CH-IMCEXCE060055",
          "type": "CDM"
        },
        {
          "code": "J1642",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.64,
          "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": 0.41
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.64,
              "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": 0.54
            },
            {
              "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": 0.64,
              "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": 0.42
            },
            {
              "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.48
            },
            {
              "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": 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": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 0.64,
              "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": 0.47
            },
            {
              "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": "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": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.52,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 0.64,
              "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": 0.64,
              "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": 0.54
            },
            {
              "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": 0.64,
              "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": 0.64,
              "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": 0.35
            },
            {
              "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": 0.64,
              "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": 0.52
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.64,
              "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": 0.64,
              "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.52
            },
            {
              "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": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "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": 0.64,
              "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": 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": 0.41
            },
            {
              "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": 0.64,
              "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": 0.64,
              "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": 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": 0.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.53
            },
            {
              "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": 0.64,
              "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": 0.54
            },
            {
              "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": 0.64,
              "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": 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": 0.41
            },
            {
              "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": 0.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.41
            },
            {
              "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": 0.64,
              "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": 0.64,
              "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": 0.64,
              "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": 0.64
            },
            {
              "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": 0.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.64,
              "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": 0.64,
              "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": 0.64,
              "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": 0.54
            },
            {
              "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": 0.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 0.41
            },
            {
              "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": 0.4
            },
            {
              "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": 0.64,
              "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": 0.41
            },
            {
              "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": 0.64,
              "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": 0.52
            },
            {
              "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": 0.64,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "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": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 0.41
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.56
            },
            {
              "payer_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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.64,
              "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": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.64,
              "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": 0.35
            },
            {
              "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": 0.64,
              "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": 0.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 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": 0.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 0.54
            },
            {
              "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": "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.64,
              "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": 0.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "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": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.64,
              "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": 0.64,
              "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": 0.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.52
            },
            {
              "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": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            }
          ],
          "minimum": 0.52,
          "maximum": 0.52
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Good Shepherd",
      "code_information": [
        {
          "code": "PX-65900208",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 270.62,
          "discounted_cash": 175.9,
          "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": 173.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 230.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 270.62,
              "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": 197.55
            },
            {
              "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": 230.03
            },
            {
              "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": 171.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.55
            },
            {
              "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": 237.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 221.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.03
            },
            {
              "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": 173.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.03
            },
            {
              "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": 197.55
            },
            {
              "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": 270.62,
              "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": 218.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 148.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.03
            },
            {
              "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": 173.74
            },
            {
              "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": 221.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 224.34
            },
            {
              "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": 238.15
            },
            {
              "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": 224.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.17
            },
            {
              "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": 150.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 218.93
            },
            {
              "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": 73.88
            },
            {
              "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": 171.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.03
            },
            {
              "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": 230.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.91
            },
            {
              "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": 221.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 270.62,
              "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": 148.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 270.62,
              "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": 176.17
            },
            {
              "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": 176.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.03
            },
            {
              "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": 173.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 173.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.91
            },
            {
              "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": 150.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.84
            },
            {
              "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": 173.74
            },
            {
              "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": 176.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 230.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 230.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 270.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 270.62,
              "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": 270.62,
              "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": 230.03
            },
            {
              "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": 221.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 224.34
            },
            {
              "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": 171.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 270.62,
              "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": 173.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.84
            },
            {
              "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": 237.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.62,
              "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": 230.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.97
            },
            {
              "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": 150.19
            }
          ]
        }
      ]
    },
    {
      "description": "Fecal Collector, Flexi-Seal",
      "code_information": [
        {
          "code": "PX-CH-CV6500-78",
          "type": "CDM"
        },
        {
          "code": "A4330",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.24,
          "discounted_cash": 7.96,
          "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": 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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.24,
              "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": 10.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 12.24,
              "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": 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": 10.04
            },
            {
              "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": 7.86
            },
            {
              "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": 10.77
            },
            {
              "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": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 6.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 12.24,
              "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": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 8.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.15
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 10.4
            },
            {
              "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": 8.94
            },
            {
              "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": 10.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.4
            },
            {
              "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": 6.79
            },
            {
              "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 7.96
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 7.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 10.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.04
            },
            {
              "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": 10.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.04
            },
            {
              "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": 3.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.79
            },
            {
              "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": 10.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "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": 7.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.24
            },
            {
              "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": 12.24,
              "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": 12.24,
              "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": 6.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.24,
              "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": 7.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 12.24,
              "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": 7.74
            },
            {
              "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": 12.24,
              "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": 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": 7.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 10.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "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": 10.73
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 9.18
            },
            {
              "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": 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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 10.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.73
            },
            {
              "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": 10.4
            },
            {
              "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": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 9.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.4
            },
            {
              "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": 12.24,
              "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": 12.24,
              "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": 10.4
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.73
            },
            {
              "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": 9.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "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": 10.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Ag Non-Adhesive Mepilex 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-SM287100",
          "type": "CDM"
        },
        {
          "code": "A6209",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.35,
          "discounted_cash": 10.63,
          "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": 10.5
            },
            {
              "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": "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": "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": 16.35,
              "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": 14.34
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.35,
              "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": 10.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.55
            },
            {
              "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": "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": "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": "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": "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.35,
              "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": 13.41
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "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": 16.35,
              "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": 16.35,
              "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": 16.35,
              "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": 13.23
            },
            {
              "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": 13.41
            },
            {
              "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": 9.07
            },
            {
              "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": "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": "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.35,
              "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": 13.9
            },
            {
              "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.35,
              "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": 16.35,
              "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": 10.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.55
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "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": 16.35,
              "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": 13.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "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": 10.5
            },
            {
              "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": 10.64
            },
            {
              "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": "AETNA [310]",
              "plan_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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.35,
              "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": 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 HEALTH NETWORK OPTION [310290]",
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.35,
              "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": 9.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "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": 13.41
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.64
            },
            {
              "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": 16.35,
              "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": 11.94
            },
            {
              "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": 16.35,
              "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": 10.5
            },
            {
              "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": 13.23
            },
            {
              "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": 16.35,
              "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": 10.33
            },
            {
              "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": 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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "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": 16.35,
              "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": 13.9
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "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": 10.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "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": 16.35,
              "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": 13.41
            },
            {
              "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": 10.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "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": 4.46
            },
            {
              "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": 14.34
            },
            {
              "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": 16.35,
              "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": 8.99
            },
            {
              "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": "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": "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.35,
              "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": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Manual Appl of Stress for Joint Xray",
      "code_information": [
        {
          "code": "PX-32000242",
          "type": "CDM"
        },
        {
          "code": "77071",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 240,
          "discounted_cash": 156,
          "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": 154.08
            },
            {
              "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": 156.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 79.22,
              "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": 204
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.24
            },
            {
              "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": 80.1,
              "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": 132
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 132
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 154.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 240,
              "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": 194.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.8
            },
            {
              "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": 196.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 132
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.1,
              "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": 133.2
            },
            {
              "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": 240,
              "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": 151.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 133.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 175.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.22,
              "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": 211.2
            },
            {
              "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": 198.96
            },
            {
              "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": 80.1,
              "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": 132
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 132
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 198.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.68
            },
            {
              "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": 196.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 175.2
            },
            {
              "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": 194.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 240
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 240,
              "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": 151.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 180
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 154.08
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 175.2
            },
            {
              "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": 77.63,
              "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": 154.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 132
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 240,
              "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": 154.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.8
            },
            {
              "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": 210.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 154.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 180
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 204
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 240,
              "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": 154.08
            },
            {
              "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": 204
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.63,
              "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": 80.1,
              "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": 156.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 240,
              "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": 133.2
            },
            {
              "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": 240,
              "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": 77.63,
              "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": 210.48
            },
            {
              "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": 80.1,
              "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": 83.28,
              "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": 240,
              "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": 180
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 154.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.24
            },
            {
              "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": 240,
              "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": 83.28,
              "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": 204
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 240,
              "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": 175.2
            },
            {
              "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": 154.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 154.08
            },
            {
              "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": 77.63,
              "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": 240,
              "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": 132
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 204
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.22,
              "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": 175.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 175.2
            },
            {
              "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": 151.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 240,
              "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": 240,
              "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": 240,
              "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": 81.52,
              "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": 151.68
            },
            {
              "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": 154.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 154.08
            },
            {
              "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": 196.8
            },
            {
              "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": 65.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 133.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 198.96
            },
            {
              "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": 204
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 156
            }
          ]
        }
      ]
    },
    {
      "description": "Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 Sendout",
      "code_information": [
        {
          "code": "PX-30101367",
          "type": "CDM"
        },
        {
          "code": "0027U",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1009,
          "discounted_cash": 655.85,
          "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": 647.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 554.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 207.1,
              "estimated_amount": 207.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 554.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 656.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 637.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 121.91,
              "estimated_amount": 121.91
            },
            {
              "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": 655.85
            },
            {
              "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": 554.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 736.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 647.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 647.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "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": 827.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 207.1,
              "estimated_amount": 207.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 816.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "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": 736.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 121.91,
              "estimated_amount": 121.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.13,
              "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": 827.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "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": 1009,
              "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": 647.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 827.38
            },
            {
              "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": 827.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "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": 884.89
            },
            {
              "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": 857.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 827.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 736.57
            },
            {
              "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": 836.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 836.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 827.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 756.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 736.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "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": 560
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 637.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "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": 560
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 756.75
            },
            {
              "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": 857.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "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": 1009,
              "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": 827.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 836.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 554.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 554.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.13,
              "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": 857.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "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": 220.97
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 128.01,
              "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": 656.86
            },
            {
              "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": 887.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 128.01,
              "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": 857.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 656.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 554.95
            },
            {
              "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": 647.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1009
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 736.57
            },
            {
              "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": 656.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 637.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 121.91,
              "estimated_amount": 121.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "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": 275.46
            },
            {
              "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": 637.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 647.78
            },
            {
              "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": 647.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 656.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 756.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 128.01,
              "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": 121.91,
              "estimated_amount": 121.91
            },
            {
              "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": 560
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 647.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 736.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 121.91,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.13,
              "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": 121.91,
              "estimated_amount": 121.91
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 121.91,
              "estimated_amount": 121.91
            },
            {
              "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": 647.78
            },
            {
              "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": 816.28
            },
            {
              "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": 884.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 457.16,
              "estimated_amount": 457.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 647.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 554.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 637.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 637.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1009,
              "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": 560
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 647.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 647.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 637.69
            },
            {
              "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": 637.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 121.91,
              "estimated_amount": 121.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 827.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 857.65
            }
          ],
          "minimum": 121.91,
          "maximum": 457.16
        }
      ]
    },
    {
      "description": "\"Gauze Roll Biogaurd 4-1/2\"\" X 4.1 Yds 6ply\"",
      "code_information": [
        {
          "code": "PX-CH-DUM97322",
          "type": "CDM"
        },
        {
          "code": "A6266",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.07,
          "discounted_cash": 2,
          "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": 1.97
            },
            {
              "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": 1.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.61
            },
            {
              "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": 3.07,
              "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": 2.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 3.07,
              "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": 2.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.97
            },
            {
              "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": 2.61
            },
            {
              "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": 1.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.97
            },
            {
              "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": 3.07,
              "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": 2.61
            },
            {
              "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": 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": 3.07,
              "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": 1.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 1.69
            },
            {
              "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": 2.24
            },
            {
              "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": 1.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 3.07,
              "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": 1.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.24
            },
            {
              "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": 2.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 2.3
            },
            {
              "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": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 1.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 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": 2.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.94
            },
            {
              "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": 3.07,
              "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": 2.24
            },
            {
              "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": 2.52
            },
            {
              "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": 1.94
            },
            {
              "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": 1.7
            },
            {
              "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": 2.69
            },
            {
              "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": 3.07,
              "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": 3.07,
              "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": 2.52
            },
            {
              "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": 3.07,
              "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": 2.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 3.07,
              "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": 3.07,
              "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": 3.07
            },
            {
              "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": 1.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.69
            },
            {
              "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": 3.07,
              "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": 3.07,
              "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": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 2.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.24
            },
            {
              "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": 3.07,
              "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": 1.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.97
            },
            {
              "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": 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": 2.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 0.84
            },
            {
              "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": 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": 1.97
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.3
            },
            {
              "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": 3.07,
              "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": 1.69
            },
            {
              "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": 3.07,
              "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": 2.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 2.61
            },
            {
              "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": 2.7
            },
            {
              "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": 2.52
            },
            {
              "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": 3.07,
              "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": 2.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 3.07,
              "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": 2.61
            },
            {
              "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": 3.07,
              "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": 2.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 1.69
            },
            {
              "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": 3.07,
              "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": 63.2,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.61
            },
            {
              "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": 2.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.52
            },
            {
              "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": 3.07,
              "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": 1.69
            },
            {
              "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": 3.07,
              "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": 1.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 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": 3.07,
              "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": 3.07,
              "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": 1.97
            },
            {
              "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": 2.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.07,
              "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": 1.97
            }
          ]
        }
      ]
    },
    {
      "description": "\"Cardinal Protective Underware Mens Medium 32 to 44\"\" W\"",
      "code_information": [
        {
          "code": "PX-CH-IMCUWMSMD20",
          "type": "CDM"
        },
        {
          "code": "A4520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.15,
          "discounted_cash": 0.75,
          "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": 0.74
            },
            {
              "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": 0.93
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 1.15,
              "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": 0.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.15,
              "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": 0.73
            },
            {
              "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": 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": 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": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "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 PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 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": 1.15,
              "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": 0.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.15,
              "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": 0.84
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 1.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.84
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.98
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.63
            },
            {
              "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": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 0.75
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 1.15,
              "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": 1.15,
              "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": 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": 0.74
            },
            {
              "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": 0.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 1.15,
              "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": 1.15,
              "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": 1.15,
              "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": 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": 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": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "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": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.94
            },
            {
              "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": 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": 0.31
            },
            {
              "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": 1.01
            },
            {
              "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": 0.95
            },
            {
              "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": 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": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "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": 1.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.73
            },
            {
              "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": 1.15,
              "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": 0.75
            },
            {
              "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": "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": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.15,
              "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": 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": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.15,
              "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": 0.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.64
            }
          ]
        }
      ]
    },
    {
      "description": "HC Heart Valve 32",
      "code_information": [
        {
          "code": "PX-27800226",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 36100,
          "discounted_cash": 23465,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 23140.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29602
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19855
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "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": 23140.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27075
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29602
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36100,
              "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": 26353
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23501.1
            },
            {
              "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": 20035.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 23645.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19855
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26353
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20035.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "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": 23140.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29204.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 23140.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29602
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31768
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36100,
              "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": 26353
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23501.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20035.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 23645.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29204.9
            },
            {
              "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": 29602
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19855
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31659.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 23067.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26353
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29926.9
            },
            {
              "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": 26353
            },
            {
              "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": 23140.1
            },
            {
              "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": 23140.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36100,
              "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": 22021
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 23067.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29926.9
            },
            {
              "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": 9855.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 23140.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 23067.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 23645.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23501.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 23067.9
            },
            {
              "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": 23465
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29602
            },
            {
              "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": 23140.1
            },
            {
              "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": 23501.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26353
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29926.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30685
            },
            {
              "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": 23645.5
            },
            {
              "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": 36100,
              "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": 22021
            },
            {
              "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": 23645.5
            },
            {
              "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": 20035.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29602
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19855
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19855
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 23645.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 23140.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27075
            },
            {
              "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": 22021
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36100,
              "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": 29602
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 23140.1
            },
            {
              "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": 31659.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23501.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19855
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 23645.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 36100
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27075
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 23140.1
            },
            {
              "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": 23645.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 22021
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 23140.1
            },
            {
              "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": 29602
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19855
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Std Wear Cvx Light Up to 1 11/16 in Mio",
      "code_information": [
        {
          "code": "PX-CH-CO16748",
          "type": "CDM"
        },
        {
          "code": "A4389",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.51,
          "discounted_cash": 1.63,
          "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": 1.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 2.13
            },
            {
              "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": 2.51,
              "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": 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": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 2.13
            },
            {
              "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": 2.51,
              "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": 1.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.51,
              "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": 1.88
            },
            {
              "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": 1.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.13
            },
            {
              "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": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 1.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.38
            },
            {
              "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": 2.51,
              "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": 2.51,
              "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": 1.59
            },
            {
              "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": 2.51,
              "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": 1.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.08
            },
            {
              "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": 2.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.61
            },
            {
              "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": 2.51,
              "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": 2.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.06
            },
            {
              "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": 2.51,
              "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": 2.51,
              "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": 2.51,
              "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": 1.61
            },
            {
              "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": 2.51,
              "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": 2.51,
              "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": 2.13
            },
            {
              "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": 1.39
            },
            {
              "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": 2.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.06
            },
            {
              "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": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 2.51,
              "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": 2.51,
              "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": 1.59
            },
            {
              "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": 2.21
            },
            {
              "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": 2.06
            },
            {
              "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": 1.61
            },
            {
              "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": 1.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 2.51,
              "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": 2.51,
              "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": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.38
            },
            {
              "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": 2.51,
              "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": 2.51,
              "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": 2.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 2.51,
              "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": 2.03
            },
            {
              "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": 2.51,
              "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": 1.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.06
            },
            {
              "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": 1.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.13
            },
            {
              "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": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 2.13
            },
            {
              "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": 1.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.51,
              "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": 2.51,
              "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": 2.51,
              "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": 1.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 2.51,
              "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": 1.61
            },
            {
              "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": 1.63
            },
            {
              "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": 0.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.83
            },
            {
              "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": 2.51,
              "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": 2.51,
              "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": 1.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.59
            },
            {
              "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": 1.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.38
            },
            {
              "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": 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": 1.83
            },
            {
              "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": 2.51,
              "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": 2.51,
              "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": 2.51,
              "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": 1.38
            }
          ]
        }
      ]
    },
    {
      "description": "Alginate Ag Algicell 4 1/4 in X 4 1/4 In",
      "code_information": [
        {
          "code": "PX-CH-DUM88544",
          "type": "CDM"
        },
        {
          "code": "A6197",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.23,
          "discounted_cash": 6.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 6.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.47
            },
            {
              "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": 10.23,
              "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": 10.23,
              "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": 10.23,
              "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": 10.23,
              "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": 10.23,
              "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": 10.23,
              "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": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 10.23,
              "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": 10.23,
              "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": 10.23,
              "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": 6.47
            },
            {
              "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": 2.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.47
            },
            {
              "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": 10.23,
              "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": 8.7
            },
            {
              "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": 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": 8.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 5.63
            },
            {
              "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": 10.23,
              "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": 8.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.23
            },
            {
              "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": 6.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 5.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.28
            },
            {
              "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": 8.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.47
            },
            {
              "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": 10.23,
              "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": 8.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.57
            },
            {
              "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": 10.23,
              "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": 10.23,
              "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": 8.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.47
            },
            {
              "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": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 10.23,
              "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": 5.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 8.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.23,
              "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": 10.23,
              "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": 5.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.57
            },
            {
              "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": 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": 6.57
            },
            {
              "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": 8.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 8.7
            },
            {
              "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": 10.23,
              "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": 10.23,
              "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
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 10.23,
              "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": 8.7
            },
            {
              "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": 8.7
            },
            {
              "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": 8.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 8.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 7.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 10.23,
              "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": 8.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 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": 5.68
            },
            {
              "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": 10.23,
              "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": 8.39
            },
            {
              "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": 10.23,
              "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": 5.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.67
            },
            {
              "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": 8.7
            },
            {
              "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": 10.23,
              "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": 10.23,
              "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": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 10.23,
              "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": 5.63
            },
            {
              "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": 8.28
            },
            {
              "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": 10.23,
              "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": 10.23,
              "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": 6.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.23,
              "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": 7.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mopath Level 7 Ap So",
      "code_information": [
        {
          "code": "PX-30101374",
          "type": "CDM"
        },
        {
          "code": "81406",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6921,
          "discounted_cash": 4498.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 297.02,
              "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": 3806.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5052.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1470.2,
              "estimated_amount": 1470.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "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": 4498.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6921
            },
            {
              "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": 3460.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "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": 6090.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5190.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5190.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "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": 1515.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "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": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 566.8,
              "estimated_amount": 566.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3806.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 297.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 285.71,
              "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": 5675.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3806.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5675.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3806.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5052.33
            },
            {
              "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": 4325.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3806.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "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": 4325.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "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": 5675.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 566.8,
              "estimated_amount": 566.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 297.02,
              "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": 5882.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5052.33
            },
            {
              "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": 5675.22
            },
            {
              "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": 5675.22
            },
            {
              "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": 3806.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 196.54,
              "estimated_amount": 196.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3806.55
            },
            {
              "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": 3460.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5675.22
            },
            {
              "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": 5052.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5675.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1470.2,
              "estimated_amount": 1470.2
            },
            {
              "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": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 196.54,
              "estimated_amount": 196.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 196.54,
              "estimated_amount": 196.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5052.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 285.71,
              "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": 5190.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 3460.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 285.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 285.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 282.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 285.71,
              "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": 5882.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6921,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5675.22
            },
            {
              "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": 5882.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1060.8,
              "estimated_amount": 1060.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5882.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 196.54,
              "estimated_amount": 196.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5052.33
            },
            {
              "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": 62.5,
              "estimated_amount": 4325.63
            },
            {
              "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": 4325.63
            },
            {
              "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": 4325.63
            },
            {
              "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": 1730.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 282.88,
              "estimated_amount": 282.88
            }
          ],
          "minimum": 196.54,
          "maximum": 1470.2
        }
      ]
    },
    {
      "description": "Feeding Tube Declogger Orange 18-24fr Peg Type",
      "code_information": [
        {
          "code": "PX-CH-BIO922",
          "type": "CDM"
        },
        {
          "code": "B9998",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.04,
          "discounted_cash": 5.88,
          "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": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "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": 7.31
            },
            {
              "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": 4.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 7.68
            },
            {
              "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": 5.02
            },
            {
              "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": 7.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "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": 5.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.71
            },
            {
              "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": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 4.97
            },
            {
              "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": 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": 5.8
            },
            {
              "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": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 5.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.6
            },
            {
              "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": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 4.97
            },
            {
              "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": 5.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.78
            },
            {
              "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": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 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": 6.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 6.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.02
            },
            {
              "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": 5.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 7.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "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": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 7.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "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": 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": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 7.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 7.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 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": 6.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.31
            },
            {
              "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": 5.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 5.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 5.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 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": 6.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.6
            },
            {
              "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": 7.49
            },
            {
              "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": 7.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "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": 5.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 7.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 7.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 7.68
            },
            {
              "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": 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": 7.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 4.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "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": 7.68
            },
            {
              "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": 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": 2.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 7.68
            },
            {
              "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": 5.8
            },
            {
              "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": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "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": 7.96
            },
            {
              "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": 6.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 5.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.6
            },
            {
              "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": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.49
            },
            {
              "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": 6.6
            },
            {
              "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": 5.8
            },
            {
              "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": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 5.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.78
            },
            {
              "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": 7.68
            },
            {
              "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": 5.71
            },
            {
              "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": 5.71
            },
            {
              "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": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 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": 6.6
            },
            {
              "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": 7.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.49
            },
            {
              "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": 7.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.04,
              "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": 6.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "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": 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": 5.8
            },
            {
              "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": 7.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "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": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 5.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 7.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 5.8
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 22.75,
          "discounted_cash": 14.79,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.61
            },
            {
              "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": 22.75,
              "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": 12.51
            },
            {
              "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": 22.75,
              "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": 22.75,
              "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": 14.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 22.75,
              "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": 14.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 18.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.66
            },
            {
              "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": 12.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 12.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.61
            },
            {
              "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": 19.34
            },
            {
              "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": 14.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "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": 22.75,
              "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": 14.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 22.75,
              "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": 22.75,
              "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": 22.75,
              "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": 14.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.61
            },
            {
              "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": 22.75,
              "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": 17.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 22.75,
              "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": 19.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 22.75,
              "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": 19.34
            },
            {
              "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": 18.4
            },
            {
              "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": 14.81
            },
            {
              "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": 6.21
            },
            {
              "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": 22.75,
              "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": 19.34
            },
            {
              "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": 22.75,
              "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": 19.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.61
            },
            {
              "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": 22.75,
              "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": 12.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.34
            },
            {
              "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": 18.66
            },
            {
              "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": 18.66
            },
            {
              "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": 20.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.81
            },
            {
              "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": 14.38
            },
            {
              "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": 22.75,
              "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": 22.75,
              "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": 22.75,
              "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": 22.75,
              "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": 12.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.86
            },
            {
              "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": 14.61
            },
            {
              "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": 12.63
            },
            {
              "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": 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": 14.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.34
            },
            {
              "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": 22.75,
              "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": 22.75,
              "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": 22.75,
              "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": 19.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.61
            },
            {
              "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": 19.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 14.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 17.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.66
            },
            {
              "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": 12.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22.75,
              "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": 19.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22.75,
              "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": 16.61
            },
            {
              "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": 22.75,
              "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": 22.75,
              "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": 14.61
            },
            {
              "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": 18.66
            },
            {
              "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": 14.38
            },
            {
              "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": 16.61
            },
            {
              "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": 14.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 22.75
            },
            {
              "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": 22.75,
              "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": 14.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.66
            },
            {
              "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": 22.75,
              "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": 22.75,
              "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": 12.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.86
            },
            {
              "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": 18.86
            }
          ]
        }
      ]
    },
    {
      "description": "Absorption Dressing Drawtex 3 in X 39 In",
      "code_information": [
        {
          "code": "PX-CH-ELTA-00305",
          "type": "CDM"
        },
        {
          "code": "A6199",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.85,
          "discounted_cash": 22.65,
          "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": 22.37
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 22.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.89
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "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": 22.37
            },
            {
              "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": 34.85,
              "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": 34.85,
              "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": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 29.62
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 19.17
            },
            {
              "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": 22.03
            },
            {
              "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": 22.69
            },
            {
              "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": 34.85,
              "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": 29.62
            },
            {
              "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": 34.85,
              "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": 26.14
            },
            {
              "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": 30.56
            },
            {
              "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": "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": 34.85,
              "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": 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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "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": 29.62
            },
            {
              "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": 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": "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.34
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 25.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "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": 22.37
            },
            {
              "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": 22.69
            },
            {
              "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": 19.17
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 22.37
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 34.85,
              "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": 22.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 34.85,
              "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": 34.85,
              "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": 34.85,
              "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": 29.62
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 30.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.14
            },
            {
              "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": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 34.85,
              "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": 28.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.89
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 34.85,
              "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": 22.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 34.85,
              "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": 34.85,
              "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": 29.62
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "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": 22.37
            },
            {
              "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": 28.58
            },
            {
              "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": 22.37
            },
            {
              "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": 34.85,
              "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": 29.62
            },
            {
              "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": "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": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.34
            },
            {
              "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": 34.85,
              "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": 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": 9.51
            },
            {
              "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": 34.85,
              "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": 22.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 29.62
            },
            {
              "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": 34.85,
              "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": 34.85,
              "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": 29.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 34.85,
              "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": 30.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.85,
              "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": 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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            }
          ]
        }
      ]
    },
    {
      "description": "\"2 Pc Pre Cut Convex Mio Click Convex Light, 1\"\" Pre-Cut\"",
      "code_information": [
        {
          "code": "PX-CH-CO16914",
          "type": "CDM"
        },
        {
          "code": "A4373",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.6,
          "discounted_cash": 5.59,
          "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": 5.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 4.77
            },
            {
              "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": "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": "AETNA [310]",
              "plan_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": "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 PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.6,
              "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": 7.13
            },
            {
              "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 BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 8.6,
              "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": 5.52
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 8.6,
              "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": 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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 6.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "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 MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.6,
              "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": 7.57
            },
            {
              "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 6.28
            },
            {
              "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": 8.6,
              "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": 4.73
            },
            {
              "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": 8.6,
              "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": 7.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.6,
              "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": 4.73
            },
            {
              "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": 8.6,
              "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": 7.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 5.52
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "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": 8.6,
              "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": 7.05
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 5.52
            },
            {
              "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": 5.52
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 6.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "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": 8.6,
              "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": 4.77
            },
            {
              "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": 8.6,
              "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": 8.6,
              "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": 5.52
            },
            {
              "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": 7.05
            },
            {
              "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": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 7.05
            },
            {
              "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": "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "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": 5.52
            },
            {
              "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": 5.52
            },
            {
              "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.96
            },
            {
              "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": 5.6
            },
            {
              "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": 7.05
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 5.44
            },
            {
              "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": 8.6,
              "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": 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": "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": "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": "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": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "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/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.6,
              "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": 8.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Hand Sanitizer Purell 8 Oz Pump Bottle",
      "code_information": [
        {
          "code": "PX-CH-FJ2070079",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.72,
          "discounted_cash": 5.67,
          "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": 5.6
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "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 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": "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": "BUCKEYE COMMUNITY 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": "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/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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "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": "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": "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 HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "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": 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": 4.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.72,
              "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": 7.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "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": 5.51
            },
            {
              "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": "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": "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": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "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": 5.51
            },
            {
              "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 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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 4.8
            },
            {
              "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.54
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.72
            },
            {
              "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": "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": "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 TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.05
            },
            {
              "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": "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": "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": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "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": 4.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 7.65
            },
            {
              "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 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 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": "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": "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": "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": "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": "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": "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": "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 [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": "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": "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": "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 [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": "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": "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": "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "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": 5.51
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.54
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": 5.6
            },
            {
              "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": "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": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": 5.6
            },
            {
              "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": 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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": "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": "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": "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": "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/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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": "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 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 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": "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 8.72,
              "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": 5.68
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "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": 5.6
            },
            {
              "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": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "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": "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": "AETNA [310]",
              "plan_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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.68
            },
            {
              "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": 7.15
            },
            {
              "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": 5.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "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": "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": "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
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.72,
              "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": 5.6
            },
            {
              "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": 5.68
            },
            {
              "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": 4.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "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": "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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "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": 7.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 8.72,
              "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": 5.68
            },
            {
              "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": 4.84
            },
            {
              "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": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "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": 6.37
            },
            {
              "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": 7.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.72
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 248.12,
          "discounted_cash": 161.28,
          "payers_information": [
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 203.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 210.9
            },
            {
              "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": 156.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 203.46
            },
            {
              "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": 203.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.13
            },
            {
              "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": 248.12,
              "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": 181.13
            },
            {
              "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": 159.29
            },
            {
              "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": 159.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 203.46
            },
            {
              "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": 218.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 248.12,
              "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": 248.12,
              "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": 210.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 205.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 205.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 248.12,
              "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": 136.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.47
            },
            {
              "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": 159.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 186.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.47
            },
            {
              "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": 67.74
            },
            {
              "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": 137.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 210.9
            },
            {
              "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": 217.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 186.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 205.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 248.12,
              "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": 248.12,
              "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": 159.29
            },
            {
              "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": 159.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 203.46
            },
            {
              "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": 137.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 210.9
            },
            {
              "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": 136.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 210.9
            },
            {
              "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": 156.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 248.12,
              "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": 248.12
            },
            {
              "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": 137.71
            },
            {
              "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": 161.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 161.53
            },
            {
              "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": 217.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.29
            },
            {
              "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": 210.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 137.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 210.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 161.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 248.12,
              "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": 210.9
            },
            {
              "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": 200.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 203.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 203.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.13
            },
            {
              "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": 248.12,
              "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": 156.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 156.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 210.9
            },
            {
              "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": 161.53
            },
            {
              "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": 159.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 210.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 200.73
            },
            {
              "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": 181.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 161.53
            },
            {
              "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": 203.46
            },
            {
              "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": 210.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 210.9
            },
            {
              "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": 161.28
            },
            {
              "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": 248.12,
              "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": 156.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "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": 248.12,
              "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": 159.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 186.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 248.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Heel & Elbow Protector Heelbo Xxl Beige Ea = 1 (Pair)",
      "code_information": [
        {
          "code": "PX-CH-BH12041",
          "type": "CDM"
        },
        {
          "code": "E0191",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14.79,
          "discounted_cash": 9.61,
          "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": 9.5
            },
            {
              "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": 12.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 9.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 8.13
            },
            {
              "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": 9.63
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 14.79
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 9.35
            },
            {
              "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": 9.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 9.5
            },
            {
              "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": 9.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 14.79,
              "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": 14.79,
              "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": 14.79,
              "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": 14.79,
              "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": 12.13
            },
            {
              "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": 9.5
            },
            {
              "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": 9.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.97
            },
            {
              "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": 12.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.79,
              "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": 12.13
            },
            {
              "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": 9.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 12.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.09
            },
            {
              "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": 9.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 12.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 9.5
            },
            {
              "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": 9.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "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": 14.79,
              "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": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.21
            },
            {
              "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": 8.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 14.79
            },
            {
              "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": 8.13
            },
            {
              "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": 8.13
            },
            {
              "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": 14.79,
              "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": 9.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.63
            },
            {
              "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": 11.97
            },
            {
              "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": 12.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.09
            },
            {
              "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": 12.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "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": 9.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 9.35
            },
            {
              "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": 9.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 14.79,
              "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": 14.79,
              "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": 8.13
            },
            {
              "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": 10.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 12.13
            },
            {
              "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": 8.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 12.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "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": 9.63
            },
            {
              "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": 12.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 12.57
            },
            {
              "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": 13.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 8.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 11.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 9.5
            },
            {
              "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": 9.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 12.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "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": 8.21
            },
            {
              "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": 12.26
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 8.21
            },
            {
              "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": 12.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.35
            },
            {
              "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": 9.35
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "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": 13.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 8.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 9.5
            },
            {
              "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": 12.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "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": 8.21
            },
            {
              "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": 12.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "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": 9.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.35
            },
            {
              "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": 9.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 10.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 14.79,
              "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": 12.57
            },
            {
              "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": 9.5
            },
            {
              "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": 9.5
            },
            {
              "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": 9.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.63
            },
            {
              "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": 4.04
            },
            {
              "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": 12.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.09
            },
            {
              "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": 12.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 12.57
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 14.79,
              "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": 8.21
            },
            {
              "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": 4.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.79,
              "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": 12.26
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 14.24,
          "discounted_cash": 9.26,
          "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": 9.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.1
            },
            {
              "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": 7.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.83
            },
            {
              "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": 11.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 12.1
            },
            {
              "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": 14.24,
              "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": 12.1
            },
            {
              "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": 14.24,
              "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": 14.24,
              "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": 9.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.14
            },
            {
              "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": 3.89
            },
            {
              "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": 9.27
            },
            {
              "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": 14.24,
              "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": 14.24,
              "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": 14.24,
              "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": 14.24,
              "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": 14.24,
              "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": 7.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 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": 11.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.27
            },
            {
              "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": 11.68
            },
            {
              "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": 12.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.83
            },
            {
              "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": 9.14
            },
            {
              "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": 14.24,
              "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": 14.24,
              "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": 10.4
            },
            {
              "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": 14.24,
              "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": 11.68
            },
            {
              "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": 7.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.83
            },
            {
              "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": 14.24,
              "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": 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": 14.24,
              "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": 9.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 12.49
            },
            {
              "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": 9.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.1
            },
            {
              "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": 14.24,
              "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": 10.4
            },
            {
              "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": 14.24,
              "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": 14.24,
              "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": 7.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.83
            },
            {
              "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": 11.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 12.1
            },
            {
              "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": 9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.68
            },
            {
              "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": 14.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 12.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.68
            },
            {
              "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": 10.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.1
            },
            {
              "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": 14.24,
              "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": 9.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 11.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.24,
              "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": 9.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 7.83
            },
            {
              "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": 14.24,
              "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": 12.53
            },
            {
              "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": 9.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.14
            },
            {
              "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": 12.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 11.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 12.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 14.24,
              "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": 9.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.1
            },
            {
              "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": 14.24,
              "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": 14.24,
              "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": 9.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 14.24,
              "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": 14.24,
              "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": 10.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.24,
              "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": 14.24,
              "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": 14.24
            },
            {
              "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": 11.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.8
            },
            {
              "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": 9
            }
          ]
        }
      ]
    },
    {
      "description": "\"Underpad 23\"\" X 36\"\" Prevail First Quality Green Heavy\"",
      "code_information": [
        {
          "code": "PX-CH1QUP120",
          "type": "CDM"
        },
        {
          "code": "A4554",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.33,
          "discounted_cash": 0.21,
          "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": 0.21
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.27
            },
            {
              "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": 0.21
            },
            {
              "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": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.33,
              "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": 0.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.25
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "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": 0.21
            },
            {
              "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": 0.27
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.27
            },
            {
              "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.25
            },
            {
              "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": 0.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.33,
              "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": 0.28
            },
            {
              "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": 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": 0.24
            },
            {
              "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": 0.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.27
            },
            {
              "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": 0.27
            },
            {
              "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": 0.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.25
            },
            {
              "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": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.33,
              "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": 0.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "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": 0.33,
              "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": 0.25
            },
            {
              "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": 0.27
            },
            {
              "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": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.29
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.18
            },
            {
              "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": 0.29
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.33,
              "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": 0.21
            },
            {
              "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": 0.18
            },
            {
              "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": 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": 0.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.33,
              "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": 0.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.27
            },
            {
              "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": "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": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.21
            },
            {
              "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": 0.21
            },
            {
              "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": "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": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.27
            },
            {
              "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": 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": 0.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.24
            },
            {
              "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": 0.24
            },
            {
              "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": 0.28
            },
            {
              "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": 0.21
            },
            {
              "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": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.33
            },
            {
              "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": 0.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "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": 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": 0.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.25
            },
            {
              "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": 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": 0.33,
              "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": 0.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "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": 0.33,
              "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": 0.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.28
            },
            {
              "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": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "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": 0.33,
              "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": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 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": 0.24
            },
            {
              "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": 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": 0.27
            },
            {
              "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": 0.33,
              "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": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.28
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.33,
              "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": 0.33,
              "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": 0.33,
              "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": 0.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.24
            },
            {
              "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": 0.21
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.33,
              "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": 0.29
            },
            {
              "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": 0.33,
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.21
            },
            {
              "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": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.24
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 5,
          "discounted_cash": 3.25,
          "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": 3.21
            },
            {
              "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": 5,
              "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": 4.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5,
              "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": 3.21
            },
            {
              "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": 2.78
            },
            {
              "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": 4.25
            },
            {
              "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": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5,
              "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": 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": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "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 PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "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": 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": "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": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5,
              "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": 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": 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": 5,
              "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": 5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "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": 5,
              "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": 4.1
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 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": 2.75
            },
            {
              "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 MANAGED MEDICARE [486]",
              "plan_name": "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,
              "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": 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": 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": "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": "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 UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 3.21
            },
            {
              "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": 1.37
            },
            {
              "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": 2.78
            },
            {
              "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": 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": 4.25
            },
            {
              "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": 3.21
            },
            {
              "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": 5,
              "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": 2.75
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5,
              "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": 4.25
            },
            {
              "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": "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/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5,
              "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": 4.25
            },
            {
              "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": 4.15
            },
            {
              "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": 3.16
            },
            {
              "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": 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": 4.1
            },
            {
              "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": 5,
              "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": 5,
              "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,
              "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": 3.26
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC 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,
              "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": 3.16
            },
            {
              "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": 4.1
            },
            {
              "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": "AULTCARE HEALTHREACH [540405]",
              "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": "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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,
              "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": 5,
              "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,
              "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,
              "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,
              "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": 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": 3.21
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "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": "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": "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 UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5,
              "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": 4.25
            },
            {
              "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,
              "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": 3.21
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "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": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "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": "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 OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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,
              "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": 5,
              "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,
              "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": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5,
              "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": 3.21
            },
            {
              "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": 3.26
            },
            {
              "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": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 4.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            }
          ]
        }
      ]
    },
    {
      "description": "Gloves Nitrile Powder-Free Esteem Xp Small Extended Cuff",
      "code_information": [
        {
          "code": "PX-CHA1N8851XPB",
          "type": "CDM"
        },
        {
          "code": "A4927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.14,
          "discounted_cash": 0.09,
          "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": 0.09
            },
            {
              "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": 0.11
            },
            {
              "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": 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": 0.14,
              "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": 0.09
            },
            {
              "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": "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": "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": "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 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": "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": "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": "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.09
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.1
            },
            {
              "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": "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": "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": "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": "AETNA [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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.11
            },
            {
              "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": "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": "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": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "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": "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": "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": "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "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": 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": "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": "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": "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": "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": "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": "AETNA [310]",
              "plan_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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.09
            },
            {
              "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": "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": "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": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.09
            },
            {
              "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": "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": "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": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "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": 0.14,
              "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": 0.14,
              "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": 0.12
            },
            {
              "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": 0.14,
              "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": 0.12
            },
            {
              "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": 0.14,
              "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": 0.09
            },
            {
              "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.11
            },
            {
              "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": "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.09
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "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": "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 HEALTH FUND [310250]",
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.09
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.12
            },
            {
              "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": 0.08
            },
            {
              "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": 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": "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
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 25.64,
          "discounted_cash": 16.67,
          "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": 16.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.64,
              "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": 16.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.1
            },
            {
              "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": 18.72
            },
            {
              "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": 16.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 22.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.23
            },
            {
              "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": 16.2
            },
            {
              "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": 16.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 16.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 16.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.46
            },
            {
              "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": 21.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 16.46
            },
            {
              "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": 14.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 18.72
            },
            {
              "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": 25.64,
              "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": 21.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 14.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 25.64,
              "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": 21.02
            },
            {
              "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": 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": 20.74
            },
            {
              "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": 21.02
            },
            {
              "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": 25.64,
              "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": 16.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 18.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 14.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.69
            },
            {
              "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": 21.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 25.64,
              "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": 25.64,
              "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": 21.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 21.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.64,
              "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": 14.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.46
            },
            {
              "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": 22.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.1
            },
            {
              "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": 25.64,
              "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": 16.2
            },
            {
              "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": 21.02
            },
            {
              "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": 14.1
            },
            {
              "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": 21.79
            },
            {
              "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": 22.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.02
            },
            {
              "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": 21.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.46
            },
            {
              "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": 16.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.02
            },
            {
              "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": 16.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 25.64,
              "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": 14.23
            },
            {
              "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": 16.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 19.23
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.72
            },
            {
              "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": 16.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.64,
              "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": 25.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.79
            }
          ]
        }
      ]
    },
    {
      "description": "Pitcher Water 28oz",
      "code_information": [
        {
          "code": "PX-CHACH22210",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.04,
          "discounted_cash": 0.68,
          "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": 0.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.68
            },
            {
              "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": "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": "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 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.67
            },
            {
              "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": 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
            },
            {
              "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.04,
              "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": 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": 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": 0.66
            },
            {
              "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 CHOICE [625225]",
              "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.88
            },
            {
              "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": 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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.04,
              "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": 0.67
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 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": 0.67
            },
            {
              "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.04,
              "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": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "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": "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": "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": "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 NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "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": 0.85
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "AETNA [310]",
              "plan_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": "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": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.58
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.04
            },
            {
              "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": 0.58
            },
            {
              "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": 0.67
            },
            {
              "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": "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 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 OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.84
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "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": 0.66
            },
            {
              "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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "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": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "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": 0.76
            },
            {
              "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": 0.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "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": 0.67
            },
            {
              "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": 0.67
            },
            {
              "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "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": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.66
            },
            {
              "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": "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": "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": "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": "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "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": 0.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "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": "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": "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": "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": "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": "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 HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "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": "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": "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 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": "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": "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": "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.78
            },
            {
              "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": "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": "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": "AETNA [310]",
              "plan_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": "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": "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": "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": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "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": 0.91
            },
            {
              "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "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": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "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": 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": 0.85
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "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": "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.04,
              "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": 0.66
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "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": 0.68
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "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": 0.66
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "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": "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": "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": "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": "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 GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "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": 0.92
            },
            {
              "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": 0.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.86
            },
            {
              "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": 0.84
            },
            {
              "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": 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": 0.85
            },
            {
              "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": 0.86
            },
            {
              "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": "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.67
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 25,
          "discounted_cash": 16.25,
          "payers_information": [
            {
              "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,
              "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": 21.25
            },
            {
              "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": 13.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25,
              "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": 21.25
            },
            {
              "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": 13.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.73
            },
            {
              "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": 16.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "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": 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": 13.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25,
              "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": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 16.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "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": 20.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25,
              "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": 18.25
            },
            {
              "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,
              "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": 21.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25,
              "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": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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,
              "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": 21.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "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": 13.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25,
              "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": 21.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.75
            },
            {
              "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
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25,
              "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": 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": 21.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "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": 20.5
            },
            {
              "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": 21.93
            },
            {
              "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": 25,
              "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": 16.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "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": 16.05
            },
            {
              "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": 13.75
            },
            {
              "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": 21.25
            },
            {
              "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": 20.73
            },
            {
              "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": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 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": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 20.5
            },
            {
              "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": 16.05
            },
            {
              "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": 16.05
            },
            {
              "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": 16.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25,
              "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": 16.28
            },
            {
              "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": 20.23
            },
            {
              "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": 25,
              "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": 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,
              "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": 13.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "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": 18.25
            },
            {
              "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": 25,
              "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": 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": 15.8
            },
            {
              "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": 21.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 25,
              "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": 18.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.73
            },
            {
              "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": 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": 18.75
            }
          ]
        }
      ]
    },
    {
      "description": "Gastrostomy Tube Mic-Key 12 in Extension",
      "code_information": [
        {
          "code": "PX-CHBL012312",
          "type": "CDM"
        },
        {
          "code": "B9998",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20.66,
          "discounted_cash": 13.43,
          "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": 13.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 13.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "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": 17.56
            },
            {
              "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": 17.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "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": 13.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "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": 17.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "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": 13.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 17.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 17.13
            },
            {
              "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": 13.26
            },
            {
              "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": 11.47
            },
            {
              "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": 11.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "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": 15.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "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": 13.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 17.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 20.66,
              "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": 17.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "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": 16.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20.66,
              "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": 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": 11.47
            },
            {
              "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": 11.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "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": 13.45
            },
            {
              "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": 16.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "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": 5.64
            },
            {
              "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": 13.45
            },
            {
              "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": 16.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "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": 18.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 17.56
            },
            {
              "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": 13.45
            },
            {
              "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": 11.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "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": 17.56
            },
            {
              "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": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 11.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.5
            },
            {
              "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": 11.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "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": 5.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "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": 18.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 11.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 13.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 17.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20.66,
              "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": 11.36
            },
            {
              "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": 17.13
            },
            {
              "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": 17.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.5
            },
            {
              "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": 18.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "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": 11.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "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": 13.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 17.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 13.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 15.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20.66,
              "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": 16.94
            },
            {
              "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": 16.94
            },
            {
              "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": 16.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 15.08
            },
            {
              "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": 18.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "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": 16.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 17.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.5
            },
            {
              "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": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 17.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            },
            {
              "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": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 17.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "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": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "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": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 17.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 20.66,
              "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": 20.66,
              "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": 20.66,
              "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": 17.56
            },
            {
              "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": 18.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.36
            },
            {
              "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": 13.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "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": 16.94
            },
            {
              "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": 11.47
            },
            {
              "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": 13.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 18.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.66,
              "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": 11.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 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": 16.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.56
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 1.43,
          "discounted_cash": 0.93,
          "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": 1.07
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.92
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.22
            },
            {
              "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": 1.43,
              "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": 1.17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.79
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.93
            },
            {
              "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": 1.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.22
            },
            {
              "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": 1.43,
              "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": 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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 0.79
            },
            {
              "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": 1.25
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 0.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.79
            },
            {
              "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": 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": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 0.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.22
            },
            {
              "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": 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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.43,
              "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": 1.22
            },
            {
              "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": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.17
            },
            {
              "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": 0.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 0.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.43,
              "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": 1.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.17
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.92
            },
            {
              "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": 0.93
            },
            {
              "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": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.43,
              "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": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "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": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.16
            },
            {
              "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": 1.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 0.92
            },
            {
              "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": 1.19
            },
            {
              "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": 1.43,
              "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": 1.43,
              "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": 1.43,
              "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": 0.39
            },
            {
              "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": 0.93
            },
            {
              "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": 1.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.43,
              "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": 1.43,
              "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": 0.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.16
            },
            {
              "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": 0.79
            },
            {
              "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": 1.22
            }
          ]
        }
      ]
    },
    {
      "description": "\"Briefs Bariatric 70\"\" to 106\"\" Waist 34 Oz Capac\"",
      "code_information": [
        {
          "code": "PX-CHPB2195",
          "type": "CDM"
        },
        {
          "code": "A4520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.66,
          "discounted_cash": 2.38,
          "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": 2.35
            },
            {
              "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": 2.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 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": 2.67
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.31
            },
            {
              "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": 3.66,
              "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": 3.11
            },
            {
              "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": 3.66,
              "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": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.66,
              "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": 3.66,
              "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": 3.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.66,
              "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": 2.01
            },
            {
              "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": 3.66,
              "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": 3.66,
              "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": 3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 2.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 2.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 3.66,
              "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": 2.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 2.38
            },
            {
              "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": 2.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 3.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 3.66,
              "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": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 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
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.38
            },
            {
              "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": 2.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 2.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.75
            },
            {
              "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": 3.21
            },
            {
              "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": 2.38
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.66,
              "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": 2.31
            },
            {
              "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": 3.66,
              "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": 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": 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": 3.66,
              "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": 2.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 3.66,
              "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": 3.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.35
            },
            {
              "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": 2.03
            },
            {
              "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": 2.38
            },
            {
              "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": 2.67
            },
            {
              "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": 3.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.11
            },
            {
              "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": 2.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.31
            },
            {
              "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": 3.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.03
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 2.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 2.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.11
            },
            {
              "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": 3.66,
              "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": 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": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 2.35
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.03
            },
            {
              "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": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "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": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 3.66,
              "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": 2.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.67
            },
            {
              "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": 2.35
            },
            {
              "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": 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
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 2.35
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 2.01
            },
            {
              "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": 2.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.31
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.11
            },
            {
              "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": 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": 2.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 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": 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": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "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": 3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 3.22
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "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": 2.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.96
            },
            {
              "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": 2.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.11
            },
            {
              "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": 3.66,
              "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": 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": 2.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.75
            },
            {
              "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": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 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": 3.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 3.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.66
            },
            {
              "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": 3.66,
              "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": 2.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "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": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3.66,
              "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": 3.66,
              "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": 3.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.35
            },
            {
              "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": 2.38
            },
            {
              "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": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.66,
              "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": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.01
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection; Intra-Arterial",
      "code_information": [
        {
          "code": "PX-26000010",
          "type": "CDM"
        },
        {
          "code": "96373",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 349,
          "discounted_cash": 226.85,
          "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": 224.06
            },
            {
              "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": 286.18
            },
            {
              "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": 226.85
            },
            {
              "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": 289.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 191.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 220.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 296.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 227.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 220.57
            },
            {
              "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": 224.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 349,
              "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": 349,
              "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": 261.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 296.65
            },
            {
              "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": 254.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.06
            },
            {
              "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": 227.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 227.2
            },
            {
              "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": 95.28
            },
            {
              "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": 306.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 296.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 286.18
            },
            {
              "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": 286.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 254.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 193.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 282.34
            },
            {
              "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": 193.7
            },
            {
              "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": 349,
              "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": 306.07
            },
            {
              "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": 193.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 254.77
            },
            {
              "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": 296.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 296.65
            },
            {
              "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": 296.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 254.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 349,
              "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": 296.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 286.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 261.75
            },
            {
              "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": 220.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 349,
              "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": 296.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 286.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 296.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 307.12
            },
            {
              "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": 220.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 349,
              "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": 349
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 193.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 191.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 220.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 296.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 296.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 261.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 220.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 296.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 289.32
            },
            {
              "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": 191.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 191.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 349,
              "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": 286.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 286.18
            },
            {
              "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": 227.2
            },
            {
              "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": 349,
              "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": 349,
              "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": 254.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 220.57
            },
            {
              "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": 349,
              "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": 224.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.06
            },
            {
              "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": 224.06
            },
            {
              "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": 282.34
            },
            {
              "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": 224.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 254.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 224.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 227.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 349,
              "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": 191.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 191.95
            },
            {
              "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": 224.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 289.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 220.57
            },
            {
              "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": 349,
              "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": 286.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 191.95
            }
          ]
        }
      ]
    },
    {
      "description": "HC Nasal Endoscopy With Maxillary Sinusoscopy",
      "code_information": [
        {
          "code": "PX-51000111",
          "type": "CDM"
        },
        {
          "code": "31233",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1972,
          "discounted_cash": 1281.8,
          "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": 1266.02
            },
            {
              "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": 1283.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1617.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1617.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1084.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1676.2
            },
            {
              "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": 1266.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1283.77
            },
            {
              "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": 1266.02
            },
            {
              "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": 538.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1084.6
            },
            {
              "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": 1729.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1246.3
            },
            {
              "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": 1084.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1439.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1283.77
            },
            {
              "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": 1246.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1972,
              "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": 1479
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1595.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1676.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1479
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1972,
              "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": 1439.56
            },
            {
              "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": 1972,
              "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": 1617.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1676.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1283.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1266.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1617.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1084.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1972,
              "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": 1676.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1094.46
            },
            {
              "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": 1266.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1084.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1972,
              "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": 1972,
              "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": 1676.2
            },
            {
              "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": 1595.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1676.2
            },
            {
              "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": 1283.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1479
            },
            {
              "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": 1972,
              "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": 1735.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1266.02
            },
            {
              "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": 1972,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1676.2
            },
            {
              "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": 1281.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1266.02
            },
            {
              "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": 1617.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1084.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1246.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1972,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1439.56
            },
            {
              "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": 1972,
              "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": 1617.04
            },
            {
              "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": 1729.44
            },
            {
              "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": 1246.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1676.2
            },
            {
              "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": 1094.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1266.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1617.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1246.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1676.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1972
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1266.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1266.02
            },
            {
              "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": 1439.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1676.2
            },
            {
              "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": 1094.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1266.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1634.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1634.79
            },
            {
              "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": 1676.2
            },
            {
              "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": 1246.3
            },
            {
              "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": 1266.02
            },
            {
              "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": 1094.46
            },
            {
              "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": 1634.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1084.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1676.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1246.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1439.56
            },
            {
              "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": 1617.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1439.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1972,
              "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": 1246.3
            }
          ]
        }
      ]
    },
    {
      "description": "HC St Functional Activity",
      "code_information": [
        {
          "code": "PX-44000043",
          "type": "CDM"
        },
        {
          "code": "97530",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 190,
          "discounted_cash": 123.5,
          "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": 121.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 138.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 120.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 34.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "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": 123.5
            },
            {
              "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": 190,
              "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": 121.98
            },
            {
              "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": 34.7
            },
            {
              "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": 34.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 104.5
            },
            {
              "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": 104.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 138.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 138.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "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": 190,
              "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": 120.08
            },
            {
              "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": 190,
              "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": 104.5
            },
            {
              "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": 190,
              "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": 105.45
            },
            {
              "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": 34.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.98
            },
            {
              "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": 120.08
            },
            {
              "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": 166.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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_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": 34.7
            },
            {
              "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": 161.5
            },
            {
              "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": 167.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 104.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 155.8
            },
            {
              "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": 120.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 104.5
            },
            {
              "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": 34.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.98
            },
            {
              "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": 123.69
            },
            {
              "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": 34.28
            },
            {
              "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": 105.45
            },
            {
              "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": 105.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 34.7
            },
            {
              "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": 121.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 104.5
            },
            {
              "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": 138.7
            },
            {
              "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": 34.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 51.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 142.5
            },
            {
              "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": 105.45
            },
            {
              "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": 34.7
            },
            {
              "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": 155.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 190,
              "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": 161.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 121.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 190,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 34.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 120.08
            },
            {
              "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": 34.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 138.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 123.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 155.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 155.8
            },
            {
              "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": 155.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 142.5
            },
            {
              "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": 155.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 155.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 120.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "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": 36.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "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": 161.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 190,
              "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": 121.98
            },
            {
              "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": 190,
              "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": 104.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 155.8
            },
            {
              "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": 166.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 161.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "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": 123.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 123.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 120.08
            },
            {
              "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": 190,
              "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": 161.5
            },
            {
              "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": 157.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 161.5
            },
            {
              "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": 153.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 138.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 157.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 190,
              "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": 190
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 121.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 190,
              "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": 121.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 123.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "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": 121.98
            },
            {
              "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": 120.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 161.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 190,
              "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": 34.7
            },
            {
              "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": 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": 157.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 142.5
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Tray Foley Safety-Flo 16 Fr Hydrophilic -Coated",
      "code_information": [
        {
          "code": "PX-CHBA907716",
          "type": "CDM"
        },
        {
          "code": "A4314",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20.34,
          "discounted_cash": 13.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.24
            },
            {
              "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": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 20.34,
              "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": 20.34,
              "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": 13.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 20.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.29
            },
            {
              "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": 13.06
            },
            {
              "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": 5.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.34,
              "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": 20.34,
              "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": 15.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.06
            },
            {
              "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": 20.34,
              "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": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 20.34,
              "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": 20.34,
              "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": 13.06
            },
            {
              "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": 20.34,
              "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": 20.34,
              "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": 20.34,
              "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": 11.19
            },
            {
              "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": 17.29
            },
            {
              "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": 20.34,
              "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": 13.06
            },
            {
              "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": 13.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 15.26
            },
            {
              "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": 17.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.19
            },
            {
              "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": 16.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.29
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.19
            },
            {
              "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": 20.34,
              "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": 13.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 17.29
            },
            {
              "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": 17.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 12.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.24
            },
            {
              "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": 13.24
            },
            {
              "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": 11.29
            },
            {
              "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": 12.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.85
            },
            {
              "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": 20.34,
              "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": 13.06
            },
            {
              "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": 20.34,
              "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": 13.06
            },
            {
              "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": 13.24
            },
            {
              "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": 16.68
            },
            {
              "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": 20.34,
              "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": 20.34,
              "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": 20.34,
              "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": 20.34,
              "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": 20.34,
              "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": 17.29
            },
            {
              "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": 14.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.34,
              "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": 17.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.19
            },
            {
              "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": 11.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.29
            },
            {
              "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": 17.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 16.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 20.34,
              "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": 20.34,
              "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": 17.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 20.34,
              "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": 17.29
            },
            {
              "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": 20.34,
              "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": 15.26
            },
            {
              "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": 16.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.29
            },
            {
              "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": 11.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.85
            },
            {
              "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": 20.34,
              "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": 13.24
            },
            {
              "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": 16.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.85
            },
            {
              "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": 20.34,
              "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": 16.68
            },
            {
              "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": 11.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.85
            },
            {
              "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": 16.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.34,
              "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": 13.06
            },
            {
              "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": 20.34,
              "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": 17.29
            }
          ]
        }
      ]
    },
    {
      "description": "\"2pc Wafer Cvx Light Pre-Cut 1-1/8\"\" Mio\"",
      "code_information": [
        {
          "code": "PX-CHCO16486",
          "type": "CDM"
        },
        {
          "code": "A4373",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.51,
          "discounted_cash": 0.98,
          "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": 0.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "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": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "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": 1.51,
              "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": 1.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "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": 1.51,
              "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": 1.28
            },
            {
              "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": 1.51,
              "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": 1.51
            },
            {
              "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": 0.84
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 0.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "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": 1.51,
              "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": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "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": 1.22
            },
            {
              "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": 1.25
            },
            {
              "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": 1.51,
              "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": 1.51,
              "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": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.28
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.24
            },
            {
              "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": 1.51,
              "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": 1.28
            },
            {
              "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": 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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.24
            },
            {
              "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": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 1.25
            },
            {
              "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": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.24
            },
            {
              "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": 1.51,
              "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": 0.97
            },
            {
              "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": 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": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 0.95
            },
            {
              "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": 0.97
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 1.24
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 1.51,
              "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": 1.1
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.1
            },
            {
              "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": 1.51,
              "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": 1.32
            },
            {
              "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": 0.97
            },
            {
              "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": 1.24
            },
            {
              "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": 1.32
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 0.84
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.51,
              "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": 1.28
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.51,
              "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": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 0.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 1.1
            },
            {
              "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": 1.51,
              "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": 1.51,
              "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": 1.51,
              "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": 0.97
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.51,
              "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": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.97
            },
            {
              "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": 1.51,
              "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": 1.25
            },
            {
              "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
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cancer Antigen 15-3 (Ca 15-3) So",
      "code_information": [
        {
          "code": "PX-30200668",
          "type": "CDM"
        },
        {
          "code": "86300",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 53,
          "discounted_cash": 34.45,
          "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": 34.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "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": 53,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.42
            },
            {
              "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": 43.46
            },
            {
              "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": 38.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "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": 33.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "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": 43.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "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": 34.03
            },
            {
              "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": 34.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "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": 29.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "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_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.85,
              "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": 53,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "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": 33.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "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": 34.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "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": 34.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "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": 14.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 43.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "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": 34.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 46.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.5
            },
            {
              "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": 43.46
            },
            {
              "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": 46.64
            },
            {
              "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": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.85,
              "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": 45.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 45.05
            },
            {
              "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": 53,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 43.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "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": 34.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 42.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "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": 29.42
            },
            {
              "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": 33.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.03
            },
            {
              "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": 34.03
            },
            {
              "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": 34.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.85,
              "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": 29.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "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": 43.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "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": 46.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 29.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "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": 42.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            }
          ],
          "minimum": 20.81,
          "maximum": 78.04
        }
      ]
    },
    {
      "description": "HC Fibrin Degradation Products",
      "code_information": [
        {
          "code": "PX-30000066",
          "type": "CDM"
        },
        {
          "code": "85362",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 412,
          "discounted_cash": 267.8,
          "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": 264.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 260.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 228.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 337.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 268.21
            },
            {
              "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": 350.2
            },
            {
              "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": 268.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 337.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 337.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "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": 260.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 260.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "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": 267.8
            },
            {
              "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": 350.2
            },
            {
              "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": 333.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 268.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "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": 361.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 226.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 300.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 264.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "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": 412,
              "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": 260.38
            },
            {
              "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": 412,
              "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": 300.76
            },
            {
              "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": 337.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 309
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 264.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 337.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.06,
              "estimated_amount": 10.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 226.6
            },
            {
              "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": 361.32
            },
            {
              "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": 264.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 333.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 300.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.06,
              "estimated_amount": 10.06
            },
            {
              "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": 260.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "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": 264.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 226.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 300.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 264.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 341.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "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": 362.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 309
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 226.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 341.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 264.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 268.21
            },
            {
              "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": 341.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "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": 264.5
            },
            {
              "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": 226.6
            },
            {
              "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": 264.5
            },
            {
              "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": 337.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 260.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 264.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 226.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 337.84
            },
            {
              "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": 228.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "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": 228.66
            },
            {
              "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": 268.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 264.5
            },
            {
              "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": 337.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "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": 300.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 412
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 260.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "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": 228.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 226.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 260.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.84,
              "estimated_amount": 25.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 350.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 300.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 309
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 112.48
            },
            {
              "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": 412,
              "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": 350.2
            },
            {
              "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": 264.5
            }
          ],
          "minimum": 10.06,
          "maximum": 25.84
        }
      ]
    },
    {
      "description": "HC Thrombin Time Plasma So",
      "code_information": [
        {
          "code": "PX-30000133",
          "type": "CDM"
        },
        {
          "code": "85670",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 303,
          "discounted_cash": 196.95,
          "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": 194.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 191.5
            },
            {
              "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": 168.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "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": 194.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.83,
              "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": 221.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 248.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.77,
              "estimated_amount": 5.77
            },
            {
              "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": 191.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "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": 221.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 245.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 248.46
            },
            {
              "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": 266.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 194.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.77,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "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": 303,
              "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": 166.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.77,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.06,
              "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": 194.53
            },
            {
              "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": 82.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 194.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 227.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.8,
              "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": 197.25
            },
            {
              "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": 248.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 248.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 191.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.8,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.77,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 194.53
            },
            {
              "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": 197.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.83,
              "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": 194.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 191.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "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": 251.19
            },
            {
              "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": 191.5
            },
            {
              "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": 265.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 194.53
            },
            {
              "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": 168.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 251.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 191.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.77,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 227.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 168.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 227.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 194.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "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": 265.73
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.8,
              "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": 166.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.83,
              "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": 191.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "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": 168.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 251.19
            },
            {
              "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": 257.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 194.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 248.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.77,
              "estimated_amount": 5.77
            },
            {
              "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": 194.53
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.06,
              "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": 166.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 166.65
            },
            {
              "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": 303,
              "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": 257.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "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": 196.95
            },
            {
              "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": 194.53
            },
            {
              "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": 197.25
            },
            {
              "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": 248.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.77,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 221.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "estimated_amount": 21.64
            },
            {
              "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": 303,
              "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": 197.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            },
            {
              "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": 248.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "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": 303
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 245.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 248.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.64,
              "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": 191.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 197.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 257.55
            }
          ],
          "minimum": 5.77,
          "maximum": 21.64
        }
      ]
    },
    {
      "description": "Underpad 30 in X 36 in Quilted Wings Medical Blue",
      "code_information": [
        {
          "code": "PX-CHKNP3036C",
          "type": "CDM"
        },
        {
          "code": "A4554",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.87,
          "discounted_cash": 0.57,
          "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": 0.56
            },
            {
              "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": 0.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.48
            },
            {
              "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": 0.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.48
            },
            {
              "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": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.87,
              "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": 0.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.48
            },
            {
              "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": 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": 0.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.87,
              "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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "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": 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": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.87,
              "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": 0.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.64
            },
            {
              "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": 0.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.55
            },
            {
              "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": 0.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.74
            },
            {
              "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": 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": 0.56
            },
            {
              "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": 0.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.64
            },
            {
              "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": 0.87,
              "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": 0.87,
              "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": 0.64
            },
            {
              "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": 0.87,
              "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": 0.87,
              "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": 0.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "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": 0.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.74
            },
            {
              "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": 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": 0.56
            },
            {
              "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": 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": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.74
            },
            {
              "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": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.74
            },
            {
              "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": 0.87,
              "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": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.87,
              "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": 0.48
            },
            {
              "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": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.87,
              "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": 0.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.64
            },
            {
              "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": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.57
            },
            {
              "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": 0.87,
              "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": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.87,
              "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": 0.87,
              "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": 0.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC Nerve Conduction Studies 13 or More",
      "code_information": [
        {
          "code": "PX-92200029",
          "type": "CDM"
        },
        {
          "code": "95913",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4522,
          "discounted_cash": 2939.3,
          "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": 2903.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2903.12
            },
            {
              "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": 491.19,
              "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": 3301.06
            },
            {
              "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": 472.48,
              "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": 4522,
              "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": 3965.79
            },
            {
              "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": 4522,
              "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": 4522,
              "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": 4522,
              "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": 3391.5
            },
            {
              "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": 2487.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3301.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "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": 4522,
              "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": 2487.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2903.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4522
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3748.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2487.1
            },
            {
              "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": 472.48,
              "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": 2903.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2943.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3391.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4522,
              "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": 3843.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3708.04
            },
            {
              "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": 2939.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3301.06
            },
            {
              "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": 4522,
              "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": 2509.71
            },
            {
              "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": 2943.82
            },
            {
              "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": 3708.04
            },
            {
              "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": 467.8,
              "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": 477.34,
              "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": 3843.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "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": 472.48,
              "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": 2903.12
            },
            {
              "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": 3708.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4522,
              "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": 4522,
              "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": 4522,
              "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": 4522,
              "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": 3843.7
            },
            {
              "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": 472.48,
              "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": 472.48,
              "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": 2857.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2857.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4522,
              "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": 4522,
              "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": 4522,
              "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": 3965.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4522,
              "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": 4522,
              "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": 2487.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3301.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3708.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3301.06
            },
            {
              "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": 3748.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2857.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2857.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "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": 2903.12
            },
            {
              "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": 1234.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 491.19,
              "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": 2857.9
            },
            {
              "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": 477.34,
              "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": 2509.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3748.74
            },
            {
              "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": 4522,
              "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": 2509.71
            },
            {
              "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": 2509.71
            },
            {
              "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": 2857.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "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": 467.8,
              "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": 2487.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2943.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2903.12
            },
            {
              "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": 3658.3
            },
            {
              "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": 3843.7
            },
            {
              "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": 2857.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3658.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2487.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4522,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 990.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3708.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3708.04
            },
            {
              "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": 3301.06
            },
            {
              "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": 3979.36
            },
            {
              "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": 467.8,
              "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": 467.8,
              "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": 4522,
              "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": 4522,
              "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": 477.34,
              "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": 3843.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4522,
              "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": 2903.12
            },
            {
              "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": 2903.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2903.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3708.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3843.7
            },
            {
              "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": 3843.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2857.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3391.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2943.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2487.1
            },
            {
              "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": 2903.12
            },
            {
              "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": 2943.82
            },
            {
              "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": 3708.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2903.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4522,
              "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": 491.19,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Pre Cut Ext Wear Cvx Uro 3/4 in Premier",
      "code_information": [
        {
          "code": "PX-CHHO8482",
          "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 TRADITIONAL CHOICE INDEMNIT [310245]",
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.32
            },
            {
              "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 CHOICE [625225]",
              "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": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.45
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.84,
              "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": 6.84,
              "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": 5.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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": "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": "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": "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": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6
            },
            {
              "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 PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            },
            {
              "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": 4.32
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "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": 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": 3.8
            },
            {
              "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": 5.81
            },
            {
              "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": 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": "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 MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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"
            },
            {
              "payer_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": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "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": "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": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.84,
              "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": 5.81
            },
            {
              "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": 4.39
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 4.39
            },
            {
              "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": "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": "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 4.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 4.45
            },
            {
              "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": 1.87
            },
            {
              "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": 4.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 5.61
            },
            {
              "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": 6.84,
              "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": 4.39
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            }
          ]
        }
      ]
    },
    {
      "description": "\"Foam Pad Wheelchair 16\"\" X 16\"\" X 4\"\" Navy Rip-Stop\"",
      "code_information": [
        {
          "code": "PX-CHHFWC4443A",
          "type": "CDM"
        },
        {
          "code": "K0669",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 31.64,
          "discounted_cash": 20.57,
          "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": 20.31
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 31.64,
              "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": 26.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "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": 17.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.89
            },
            {
              "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": 26.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 31.64,
              "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": 20.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.89
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31.64,
              "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": 17.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 26.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 31.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "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": 20.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.4
            },
            {
              "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": 27.75
            },
            {
              "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": 31.64,
              "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": 27.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.94
            },
            {
              "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": 8.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 25.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 23.1
            },
            {
              "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": 17.56
            },
            {
              "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": 26.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.73
            },
            {
              "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": 25.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "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": 20.57
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.89
            },
            {
              "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": 25.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 25.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 23.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 20
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31.64,
              "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": 26.89
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31.64,
              "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": 20.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 20
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.31
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 31.64,
              "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": 20
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "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": 20.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 26.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.94
            },
            {
              "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": 31.64,
              "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": 31.64,
              "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": 20.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.75
            },
            {
              "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": 20
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.64,
              "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": 31.64,
              "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": 20.6
            }
          ]
        }
      ]
    },
    {
      "description": "HC Streptococcus Group a Amplified Probe",
      "code_information": [
        {
          "code": "PX-30600331",
          "type": "CDM"
        },
        {
          "code": "87651",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 192,
          "discounted_cash": 124.8,
          "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": 123.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 124.99
            },
            {
              "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": 157.44
            },
            {
              "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": 157.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.16
            },
            {
              "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": 123.26
            },
            {
              "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": 155.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 106.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "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": 105.6
            },
            {
              "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": 140.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 163.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.16
            },
            {
              "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": 123.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 155.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 157.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 192,
              "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": 163.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 121.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 124.99
            },
            {
              "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": 52.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "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": 168.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.34
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 159.17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.26
            },
            {
              "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": 106.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 157.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 159.17
            },
            {
              "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": 121.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.6
            },
            {
              "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": 159.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 157.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 192
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 168.38
            },
            {
              "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": 123.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 157.44
            },
            {
              "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": 106.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 144
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "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": 192,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 124.99
            },
            {
              "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": 124.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.6
            },
            {
              "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": 168.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "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": 123.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.26
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 144
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.16
            },
            {
              "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": 106.56
            },
            {
              "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": 123.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 157.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 144
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 140.16
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 192,
              "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": 105.6
            },
            {
              "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": 124.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.26
            },
            {
              "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": 157.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "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": 121.34
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 123.26
            },
            {
              "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": 124.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 121.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 163.2
            }
          ],
          "minimum": 35.09,
          "maximum": 131.59
        }
      ]
    },
    {
      "description": "Hydrocolloid Drsg Replicare 6 in X 6 In",
      "code_information": [
        {
          "code": "PX-CHUN483200",
          "type": "CDM"
        },
        {
          "code": "A6235",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.99,
          "discounted_cash": 7.79,
          "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": 7.7
            },
            {
              "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": 9.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 7.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "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": 10.55
            },
            {
              "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": 7.58
            },
            {
              "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": 6.65
            },
            {
              "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": 3.27
            },
            {
              "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": 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": 6.65
            },
            {
              "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": 9.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 11.99,
              "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": 6.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 9.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.83
            },
            {
              "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": 6.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 10.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "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": 11.99,
              "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": 8.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 8.75
            },
            {
              "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": 8.75
            },
            {
              "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": 7.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 11.99,
              "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": 11.99,
              "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": 9.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 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": 11.99,
              "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": 7.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.59
            },
            {
              "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": 11.99,
              "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": 7.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.7
            },
            {
              "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": 7.81
            },
            {
              "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": 7.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 11.99,
              "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": 9.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 11.99,
              "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": 8.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.99
            },
            {
              "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": 11.99,
              "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": 9.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.99,
              "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": 6.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.58
            },
            {
              "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": 10.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.7
            },
            {
              "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": 7.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 8.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 11.99,
              "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": 9.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 6.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 7.79
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.83
            },
            {
              "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": 10.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.99,
              "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": 11.99
            },
            {
              "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": 10.19
            },
            {
              "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": 7.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.7
            },
            {
              "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": 9.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.94
            }
          ]
        }
      ]
    },
    {
      "description": "Trcath Remove Permanent Leadless Pacer Right W Img",
      "code_information": [
        {
          "code": "PX-36100934",
          "type": "CDM"
        },
        {
          "code": "33275",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22288,
          "discounted_cash": 14487.2,
          "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": 14308.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 18944.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "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": 6084.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "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": 14308.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14509.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 16270.24
            },
            {
              "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": 22288,
              "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": 14086.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 22288,
              "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": 14308.9
            },
            {
              "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": 18276.16
            },
            {
              "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": 18276.16
            },
            {
              "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": 18030.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 22288,
              "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": 14086.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "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": 22288,
              "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": 14487.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14509.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "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": 18276.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16716
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "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": 22288,
              "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": 14308.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 19613.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18476.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14509.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "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": 19546.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18030.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22288,
              "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": 22288,
              "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": 16716
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 14308.9
            },
            {
              "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": 18476.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "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": 22288,
              "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": 22288,
              "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": 14509.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "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": 22288,
              "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": 14086.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "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": 19546.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 22288,
              "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": 12258.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 18944.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 14509.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "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": 12258.4
            },
            {
              "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": 18944.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 22288,
              "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": 14308.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16716
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "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": 14086.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18476.75
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 2 3-4 in Centerpointlock",
      "code_information": [
        {
          "code": "PX-CHHO3804",
          "type": "CDM"
        },
        {
          "code": "A5063",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.68,
          "discounted_cash": 1.09,
          "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": 1.08
            },
            {
              "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": "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": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "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": "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "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": 1.06
            },
            {
              "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 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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "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": "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 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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "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": "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 [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "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": 0.46
            },
            {
              "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": 1.68,
              "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": 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": 1.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "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": "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": "BUCKEYE COMMUNITY 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "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": "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": "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": "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.68
            },
            {
              "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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE 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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "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 MANAGED MEDICARE [624]",
              "plan_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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "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": "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": "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": "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": "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": "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": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "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": 1.38
            },
            {
              "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": 1.68,
              "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": 1.68,
              "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": 0.93
            },
            {
              "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": 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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "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 OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.47
            },
            {
              "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": 1.47
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN 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": "AETNA [310]",
              "plan_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": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.26
            },
            {
              "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": "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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.09
            },
            {
              "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": 1.68,
              "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": 0.92
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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": "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": "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": "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": "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": "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": "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": "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/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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            }
          ]
        }
      ]
    },
    {
      "description": "Foley Insert Tray W Bag 30cc Syringe, No Catheter",
      "code_information": [
        {
          "code": "PX-CHKN3532",
          "type": "CDM"
        },
        {
          "code": "A4354",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.81,
          "discounted_cash": 4.43,
          "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": 4.37
            },
            {
              "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": 6.81,
              "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": 6.81,
              "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": 3.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.75
            },
            {
              "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": 4.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 5.58
            },
            {
              "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": 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": 3.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.97
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.81,
              "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": 5.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.81,
              "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": 4.37
            },
            {
              "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": 4.43
            },
            {
              "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": 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": 6.81,
              "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": 5.79
            },
            {
              "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": 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": 4.97
            },
            {
              "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": 6.81,
              "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": 6.81,
              "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": 3.75
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.79
            },
            {
              "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": 5.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.65
            },
            {
              "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": 6.81,
              "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": 5.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.79
            },
            {
              "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": 6.81,
              "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": 6.81,
              "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": 1.86
            },
            {
              "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": 4.37
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.81,
              "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": 6.81
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.81,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.75
            },
            {
              "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": 6.81,
              "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": 6.81,
              "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": 5.79
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.81,
              "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": 6.81,
              "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": 6.81,
              "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": 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": 4.37
            },
            {
              "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": 4.43
            },
            {
              "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": 5.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.81,
              "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": 6.81,
              "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": 6.81,
              "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": 6.81,
              "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": 6.81,
              "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": 4.43
            },
            {
              "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": 6.81,
              "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": 5.65
            },
            {
              "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": 6.81,
              "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": 5.79
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.75
            },
            {
              "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": 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": 5.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.81,
              "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": 6.81,
              "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": 6.81,
              "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": 5.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "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": 4.3
            },
            {
              "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": 3.78
            },
            {
              "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": 5.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.81,
              "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": 6.81,
              "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": 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": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.81,
              "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": 6.81,
              "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": 6.81,
              "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": 4.37
            },
            {
              "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": 5.79
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.79
            },
            {
              "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": 6.81,
              "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": 6.81,
              "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": 6.81,
              "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": 5.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 5.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.51
            },
            {
              "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": 4.97
            },
            {
              "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": 4.3
            },
            {
              "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": 6.81,
              "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": 5.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.79
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Brain During Open Proc W and WO Cont",
      "code_information": [
        {
          "code": "PX-61100011",
          "type": "CDM"
        },
        {
          "code": "70559",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3172,
          "discounted_cash": 2061.8,
          "payers_information": [
            {
              "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": 2334.59
            },
            {
              "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": 2334.59
            },
            {
              "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": 2601.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 3172,
              "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": 2696.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2696.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2321.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2334.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2696.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 2331.42
            },
            {
              "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": 3172,
              "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": 3172,
              "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": 3172,
              "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": 2061.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2696.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2315.56
            },
            {
              "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": 2791.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2334.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 2696.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1744.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2379
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1744.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1744.6
            },
            {
              "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": 2696.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2334.59
            },
            {
              "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": 2064.97
            },
            {
              "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": 2064.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 3172,
              "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": 2696.2
            },
            {
              "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": 1744.6
            },
            {
              "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": 2696.2
            },
            {
              "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": 2334.59
            },
            {
              "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": 2331.42
            },
            {
              "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": 3172,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2321.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3172,
              "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": 2566.15
            },
            {
              "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": 73.6,
              "estimated_amount": 2334.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2321.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2696.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2629.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 3172,
              "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": 2315.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2315.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2601.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2334.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2601.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2321.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2696.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2601.04
            },
            {
              "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": 865.96
            },
            {
              "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": 2629.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2315.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 3172,
              "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": 2696.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2064.97
            },
            {
              "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": 2566.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2696.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 3172,
              "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": 2315.56
            },
            {
              "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": 2331.42
            },
            {
              "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": 2334.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2601.04
            },
            {
              "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": 2321.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 3172,
              "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": 2629.59
            },
            {
              "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": 3172,
              "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": 1744.6
            },
            {
              "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": 2781.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 2064.97
            },
            {
              "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": 2601.04
            },
            {
              "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": 2321.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 73.2,
              "estimated_amount": 2321.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2064.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3172,
              "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": 2601.04
            },
            {
              "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": 2331.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2334.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2601.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2379
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2379
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2321.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1744.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2315.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2334.59
            },
            {
              "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": 2781.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3172
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1744.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2334.59
            }
          ]
        }
      ]
    },
    {
      "description": "HC Lymphangiogram Extremity Unilateral",
      "code_information": [
        {
          "code": "PX-32000223",
          "type": "CDM"
        },
        {
          "code": "75801",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1090,
          "discounted_cash": 708.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 699.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 926.5
            },
            {
              "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": 699.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 903.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1090,
              "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": 893.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 893.8
            },
            {
              "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": 604.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 688.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 1090,
              "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": 1090,
              "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": 926.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 688.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 688.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 926.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 893.8
            },
            {
              "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": 699.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 817.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 599.5
            },
            {
              "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": 688.88
            },
            {
              "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": 955.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 795.7
            },
            {
              "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": 699.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 699.78
            },
            {
              "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": 709.59
            },
            {
              "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": 604.95
            },
            {
              "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": 604.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1090,
              "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": 926.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 817.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 688.88
            },
            {
              "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": 1090,
              "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": 699.78
            },
            {
              "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": 926.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 795.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 599.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 926.5
            },
            {
              "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": 688.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 699.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 1090,
              "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": 1090,
              "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": 926.5
            },
            {
              "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": 926.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 709.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 1090,
              "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": 893.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 599.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 599.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 926.5
            },
            {
              "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": 699.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 699.78
            },
            {
              "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": 893.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1090
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 893.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 817.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 599.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 903.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 699.78
            },
            {
              "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": 688.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 709.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 893.8
            },
            {
              "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": 795.7
            },
            {
              "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": 1090,
              "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": 893.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 795.7
            },
            {
              "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": 903.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 959.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 709.59
            },
            {
              "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": 297.57
            },
            {
              "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": 955.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 926.5
            },
            {
              "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": 708.5
            },
            {
              "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": 1090,
              "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": 699.78
            },
            {
              "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": 699.78
            },
            {
              "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": 709.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 795.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 795.7
            },
            {
              "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": 1090,
              "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": 881.81
            },
            {
              "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": 881.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 599.5
            },
            {
              "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": 599.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1090,
              "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": 1090,
              "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": 1090,
              "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": 688.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 604.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 926.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 926.5
            }
          ]
        }
      ]
    },
    {
      "description": "Dressing Medihoney Hcs Medihoney 2' X 2'",
      "code_information": [
        {
          "code": "PX-CHDUM31622",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.71,
          "discounted_cash": 5.66,
          "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": 5.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.36
            },
            {
              "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": 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": 4.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 7.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 7.64
            },
            {
              "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": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 4.79
            },
            {
              "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": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "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": 5.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 7.14
            },
            {
              "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": 8.71,
              "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": 5.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 6.36
            },
            {
              "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": 8.71,
              "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": 7.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 7.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "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": 8.71,
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 4.83
            },
            {
              "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": 8.71,
              "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": 8.71,
              "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": 5.59
            },
            {
              "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": 5.59
            },
            {
              "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": 8.71,
              "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": 6.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "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": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 7.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 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": 5.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.14
            },
            {
              "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": 8.71,
              "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": 7.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 6.36
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 4.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 7.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 4.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 5.59
            },
            {
              "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": 5.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.14
            },
            {
              "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": 7.14
            },
            {
              "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": 2.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 5.59
            },
            {
              "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": 8.71,
              "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": 6.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 6.36
            },
            {
              "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": 8.71,
              "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": 7.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.5
            },
            {
              "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": 8.71,
              "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": 5.59
            },
            {
              "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": 8.71,
              "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": 7.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 7.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "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": 5.59
            },
            {
              "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": 8.71,
              "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": 6.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.67
            }
          ]
        }
      ]
    },
    {
      "description": "Bcr/Abl 1 Gene Minor Bp Sendout",
      "code_information": [
        {
          "code": "PX-30101015",
          "type": "CDM"
        },
        {
          "code": "81207",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 366,
          "discounted_cash": 237.9,
          "payers_information": [
            {
              "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": 228.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 228.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 267.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 228.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 172.3,
              "estimated_amount": 172.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 201.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 228.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 267.18
            },
            {
              "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": 366,
              "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": 45,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 322.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 267.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 152.08,
              "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": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 146.29,
              "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": 144.84,
              "estimated_amount": 144.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "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": 183
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 300.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.84,
              "estimated_amount": 144.84
            },
            {
              "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": 237.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 124.23,
              "estimated_amount": 124.23
            },
            {
              "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": 201.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 146.29,
              "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": 62.5,
              "estimated_amount": 228.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 366
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 201.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "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": 228.75
            },
            {
              "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": 91.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 300.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 300.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 201.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 152.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.84,
              "estimated_amount": 144.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 366,
              "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": 45,
              "estimated_amount": 164.7
            },
            {
              "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": 164.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.84,
              "estimated_amount": 144.84
            },
            {
              "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": 183
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 267.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 124.23,
              "estimated_amount": 124.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 124.23,
              "estimated_amount": 124.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 201.3
            },
            {
              "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": 311.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 228.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "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": 62.5,
              "estimated_amount": 228.75
            },
            {
              "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": 300.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 228.75
            },
            {
              "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": 300.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 300.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.84,
              "estimated_amount": 144.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.84,
              "estimated_amount": 144.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 152.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 146.29,
              "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": 45,
              "estimated_amount": 164.7
            },
            {
              "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": 300.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 146.29,
              "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": 311.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 228.75
            },
            {
              "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": 267.18
            },
            {
              "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": 366,
              "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": 201.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 201.3
            },
            {
              "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": 164.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 300.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 172.3,
              "estimated_amount": 172.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 144.84,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 146.29,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 172.3,
              "estimated_amount": 172.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 274.5
            },
            {
              "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": 228.75
            },
            {
              "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": 228.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 124.23,
              "estimated_amount": 124.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.15,
              "estimated_amount": 543.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 267.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.84,
              "estimated_amount": 144.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 183
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 311.1
            }
          ],
          "minimum": 124.23,
          "maximum": 543.15
        }
      ]
    },
    {
      "description": "HC Hexosaminidase Total Serum So",
      "code_information": [
        {
          "code": "PX-30101036",
          "type": "CDM"
        },
        {
          "code": "83080",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 156,
          "discounted_cash": 101.4,
          "minimum": 5.76,
          "maximum": 63.26,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "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": 137.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "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": 127.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "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": 127.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "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": 132.6
            },
            {
              "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": 127.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.84,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 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": 132.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "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": 85.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "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": 113.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "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": 39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 101.4
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 156
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.84,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            }
          ]
        }
      ]
    },
    {
      "description": "HC Glucosidase Beta So",
      "code_information": [
        {
          "code": "PX-30101040",
          "type": "CDM"
        },
        {
          "code": "82963",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1547,
          "discounted_cash": 1005.55,
          "minimum": 5.35,
          "maximum": 80.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1268.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1129.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1129.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.43,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 850.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.43,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.35,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1268.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "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": 338.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 850.85
            },
            {
              "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": 1129.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 850.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.5,
              "estimated_amount": 6.5
            },
            {
              "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": 1314.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "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": 1361.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "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": 1268.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1268.54
            },
            {
              "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": 1268.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.43,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "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": 1268.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "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": 386.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.5,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1268.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1160.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 850.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1160.25
            },
            {
              "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": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 850.85
            },
            {
              "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": 1005.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 850.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.55,
              "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": 850.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.43,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1129.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1268.54
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "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": 1314.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1129.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1129.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.48,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1547
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 21.48,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "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": 1547,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.86,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 80.55,
              "estimated_amount": 80.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.35,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1160.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1314.95
            }
          ]
        }
      ]
    },
    {
      "description": "HC Power Module Cable",
      "code_information": [
        {
          "code": "PX-27400101",
          "type": "CDM"
        },
        {
          "code": "Q0508",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5020,
          "discounted_cash": 3263,
          "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": 3217.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4116.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3765
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5020
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4061.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4116.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3664.6
            },
            {
              "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": 2786.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3207.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2761
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2761
            },
            {
              "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": 3217.82
            },
            {
              "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": 4116.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4116.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2761
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3664.6
            },
            {
              "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": 3288.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3207.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5020,
              "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": 4402.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3217.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3664.6
            },
            {
              "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": 3288.1
            },
            {
              "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": 2786.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3288.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3288.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3288.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2761
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "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": 5020,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2761
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4161.58
            },
            {
              "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": 4267
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4161.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3288.1
            },
            {
              "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": 5020,
              "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": 3207.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3664.6
            },
            {
              "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": 5020,
              "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": 3217.82
            },
            {
              "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": 3268.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3268.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3288.1
            },
            {
              "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": 5020,
              "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": 3217.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3268.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2761
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3664.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3217.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3217.82
            },
            {
              "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": 3217.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3217.82
            },
            {
              "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": 4061.18
            },
            {
              "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": 1370.46
            },
            {
              "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": 3263
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2761
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "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": 3217.82
            },
            {
              "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": 3268.02
            },
            {
              "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": 4116.4
            },
            {
              "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": 3062.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4161.58
            },
            {
              "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": 2786.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3217.82
            },
            {
              "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": 4116.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3217.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4116.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4267
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3765
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4417.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3207.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4116.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2786.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3062.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3765
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4402.54
            },
            {
              "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": 3288.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3664.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3268.02
            }
          ]
        }
      ]
    },
    {
      "description": "HH Ot Neuromuscular Re Education",
      "code_information": [
        {
          "code": "PX-43100107",
          "type": "CDM"
        },
        {
          "code": "97112",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 60.5,
          "discounted_cash": 39.32,
          "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": 38.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 45.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 48.94
            },
            {
              "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": 32.15
            },
            {
              "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": 39.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 51.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 38.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 38.24
            },
            {
              "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": 32.15
            },
            {
              "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": 33.34
            },
            {
              "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": 33.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 32.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 33.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.15
            },
            {
              "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": 51.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 38.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "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": 60.5,
              "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": 38.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 51.43
            },
            {
              "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": 53.06
            },
            {
              "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": 32.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 60.5
            },
            {
              "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": 51.43
            },
            {
              "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": 32.15
            },
            {
              "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": 32.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 39.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 53.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 49.61
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.39
            },
            {
              "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": 33.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 51.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "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": 44.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "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": 39.39
            },
            {
              "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": 53.06
            },
            {
              "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": 38.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 50.15
            },
            {
              "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": 33.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "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": 60.5,
              "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": 60.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 32.15
            },
            {
              "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": 32.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 44.17
            },
            {
              "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": 32.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.84
            },
            {
              "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": 38.84
            },
            {
              "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": 38.84
            },
            {
              "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": 60.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 32.15
            },
            {
              "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": 38.84
            },
            {
              "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": 48.94
            },
            {
              "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": 49.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 32.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.61
            },
            {
              "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": 16.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 38.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.17
            },
            {
              "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": 60.5,
              "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": 60.5,
              "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": 44.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 50.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 60.5,
              "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": 60.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 32.15
            },
            {
              "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": 49.61
            },
            {
              "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": 32.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 60.5,
              "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": 33.28
            }
          ]
        }
      ]
    },
    {
      "description": "HC Transcath Stent Intrathoracic",
      "code_information": [
        {
          "code": "PX-36100771",
          "type": "CDM"
        },
        {
          "code": "37218",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 19993,
          "discounted_cash": 12995.45,
          "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": 12835.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10996.15
            },
            {
              "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": 12835.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10996.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12635.58
            },
            {
              "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": 16174.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16174.34
            },
            {
              "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": 5458.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14594.89
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19993,
              "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": 16994.05
            },
            {
              "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": 12835.51
            },
            {
              "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": 12995.45
            },
            {
              "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": 19993,
              "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": 16994.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 12835.51
            },
            {
              "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": 12835.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10996.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12835.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 19993,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 12835.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10996.15
            },
            {
              "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": 16994.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14994.75
            },
            {
              "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": 13015.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12835.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13015.44
            },
            {
              "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": 19993,
              "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": 12635.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14994.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 16574.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "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": 14594.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13015.44
            },
            {
              "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": 16394.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16394.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16394.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14594.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 19993,
              "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": 19993,
              "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": 12635.58
            },
            {
              "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": 16394.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 19993,
              "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": 19993,
              "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": 13015.44
            },
            {
              "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": 17593.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 19993,
              "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": 14594.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16394.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 19993,
              "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": 12635.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16394.26
            },
            {
              "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": 12635.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14594.89
            },
            {
              "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": 16994.05
            },
            {
              "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": 19993,
              "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": 12835.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 14594.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "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": 12835.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12635.58
            },
            {
              "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": 17533.86
            },
            {
              "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": 17533.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10996.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10996.15
            },
            {
              "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": 19993,
              "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": 12835.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19993,
              "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": 16394.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16574.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14994.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16994.05
            },
            {
              "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": 12635.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12835.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16394.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16574.2
            },
            {
              "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": 13015.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12635.58
            },
            {
              "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": 10996.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Dexa Vertebral Fracture Assess",
      "code_information": [
        {
          "code": "PX-32000225",
          "type": "CDM"
        },
        {
          "code": "77086",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 156,
          "discounted_cash": 101.4,
          "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": 100.15
            },
            {
              "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": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 132.6
            },
            {
              "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": 42.59
            },
            {
              "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": 83.28,
              "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": 79.31,
              "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": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 101.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 156,
              "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": 156,
              "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": 80.1,
              "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": 132.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 80.93,
              "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": 80.1,
              "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": 156,
              "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": 129.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "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": 86.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 127.92
            },
            {
              "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": 101.56
            },
            {
              "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": 127.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 156,
              "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": 156,
              "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": 80.1,
              "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": 132.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 129.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 156,
              "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": 156,
              "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": 98.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "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": 100.15
            },
            {
              "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": 80.93,
              "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": 98.59
            },
            {
              "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": 156,
              "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": 137.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "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": 83.28,
              "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": 83.28,
              "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": 156,
              "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": 98.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "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": 85.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "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": 132.6
            },
            {
              "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": 79.31,
              "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": 156,
              "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": 156,
              "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": 101.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 80.1,
              "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": 100.15
            },
            {
              "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": 101.56
            },
            {
              "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": 127.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 126.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "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": 156,
              "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": 80.1,
              "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": 129.32
            },
            {
              "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": 100.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "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": 98.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            },
            {
              "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": 136.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.93,
              "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": 127.92
            },
            {
              "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": 127.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 136.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 132.6
            },
            {
              "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": 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": 63.2,
              "estimated_amount": 98.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 156
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 156,
              "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": 98.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.59
            },
            {
              "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": 113.88
            },
            {
              "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": 100.15
            },
            {
              "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": 86.58
            },
            {
              "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": 156,
              "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": 85.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 126.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.8
            }
          ]
        }
      ]
    },
    {
      "description": "HC Colonoscopy Stoma W Plcmnt Endoscopic Stent",
      "code_information": [
        {
          "code": "PX-75000149",
          "type": "CDM"
        },
        {
          "code": "44402",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6233,
          "discounted_cash": 4051.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3428.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "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": 3939.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6233,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1701.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "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": 5167.16
            },
            {
              "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": 3939.26
            },
            {
              "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": 4001.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5042.5
            },
            {
              "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": 4051.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6233,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5111.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3428.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6233
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4057.68
            },
            {
              "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": 4057.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4550.09
            },
            {
              "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": 5298.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5111.06
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "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": 5466.34
            },
            {
              "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": 6233,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6233
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6233
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6233,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3939.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6233,
              "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": 5298.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4057.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4550.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 6233
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6233,
              "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": 4674.75
            },
            {
              "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": 5042.5
            },
            {
              "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": 5111.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6233,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4550.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3428.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4550.09
            },
            {
              "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": 6233,
              "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": 3428.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4550.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5111.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6233,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3939.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5111.06
            },
            {
              "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": 3939.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5111.06
            },
            {
              "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": 6233,
              "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": 4674.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4057.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3428.15
            },
            {
              "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": 5485.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3939.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5298.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3428.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4550.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5167.16
            },
            {
              "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": 4001.59
            },
            {
              "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": 5111.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3939.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4057.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3939.26
            },
            {
              "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": 5466.34
            },
            {
              "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": 4001.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5167.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6233
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5111.06
            },
            {
              "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": 4001.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3428.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4001.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4674.75
            }
          ]
        }
      ]
    },
    {
      "description": "Colonoscopy Thru Stoma W/ Submucosal Injection(S)",
      "code_information": [
        {
          "code": "PX-75000151",
          "type": "CDM"
        },
        {
          "code": "44404",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5064,
          "discounted_cash": 3291.6,
          "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": 3251.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2785.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3696.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3251.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4152.48
            },
            {
              "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": 3251.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5064,
              "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": 3200.45
            },
            {
              "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": 3200.45
            },
            {
              "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": 3251.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4152.48
            },
            {
              "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": 1109.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3352.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3251.09
            },
            {
              "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": 3696.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "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": 4304.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "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": 4441.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3200.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2785.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3296.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4096.78
            },
            {
              "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": 4152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2785.2
            },
            {
              "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": 5064,
              "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": 3798
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4441.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3696.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5064,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3251.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3352.37
            },
            {
              "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": 4304.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "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": 4096.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4152.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2785.2
            },
            {
              "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": 5064,
              "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": 3251.09
            },
            {
              "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": 3251.09
            },
            {
              "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": 3296.66
            },
            {
              "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": 2785.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3296.66
            },
            {
              "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": 1382.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3696.72
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "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": 4456.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5064,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4198.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3251.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3251.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3352.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "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": 3251.09
            },
            {
              "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": 3296.66
            },
            {
              "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": 4152.48
            },
            {
              "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": 3291.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3251.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3200.45
            },
            {
              "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": 3200.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3696.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5064,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4198.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3200.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3200.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2785.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4152.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4198.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3696.72
            },
            {
              "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": 5064,
              "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": 4304.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2785.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5064,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5064,
              "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": 4152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3798
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5064,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3296.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3200.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3798
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3352.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3235.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4304.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC Colonoscopy Flx W Encoscopic Stent Plcmnt",
      "code_information": [
        {
          "code": "PX-75000160",
          "type": "CDM"
        },
        {
          "code": "45389",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5643,
          "discounted_cash": 3667.95,
          "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": 3622.81
            },
            {
              "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": 3667.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4627.26
            },
            {
              "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": 3622.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4627.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3103.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3673.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "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": 4119.39
            },
            {
              "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": 3622.81
            },
            {
              "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": 3673.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4678.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3103.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3622.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4119.39
            },
            {
              "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": 4948.91
            },
            {
              "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": 5643,
              "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": 4232.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4627.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4678.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3622.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4119.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4119.39
            },
            {
              "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": 5643,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5643
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3566.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "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": 3673.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4627.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5643,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4948.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3622.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3622.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5643,
              "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": 4627.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4627.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3622.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5643
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3622.81
            },
            {
              "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": 3622.81
            },
            {
              "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": 4627.26
            },
            {
              "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": 3622.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3103.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3566.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4232.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3566.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3103.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4119.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5643
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3673.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3622.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4232.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3103.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4678.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "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": 3566.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4565.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4627.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3566.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3566.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "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": 1540.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3103.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3566.38
            },
            {
              "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": 5643,
              "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": 4796.55
            },
            {
              "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": 4565.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3103.65
            },
            {
              "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": 5643,
              "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": 4796.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4119.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3673.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5643
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4796.55
            },
            {
              "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": 3566.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5643
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4965.84
            }
          ]
        }
      ]
    },
    {
      "description": "HC Neg Press Wnd Disp Non Dme Ther >50cm",
      "code_information": [
        {
          "code": "PX-51000090",
          "type": "CDM"
        },
        {
          "code": "97608",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1059,
          "discounted_cash": 688.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 679.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 1059,
              "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": 1059,
              "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": 868.38
            },
            {
              "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": 365.42,
              "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": 679.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 1059,
              "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": 877.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 582.45
            },
            {
              "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": 351.5,
              "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": 351.5,
              "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": 928.74
            },
            {
              "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": 688.35
            },
            {
              "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": 231.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "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": 587.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.12,
              "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": 773.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 773.07
            },
            {
              "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": 351.5,
              "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": 348.02,
              "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": 348.02,
              "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": 1059,
              "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": 1059,
              "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": 679.88
            },
            {
              "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": 868.38
            },
            {
              "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": 669.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 868.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 900.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 669.29
            },
            {
              "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": 1059,
              "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": 582.45
            },
            {
              "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": 1059,
              "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": 679.88
            },
            {
              "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": 689.41
            },
            {
              "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": 587.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 679.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "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": 587.75
            },
            {
              "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": 1059,
              "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": 1059,
              "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": 877.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 773.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1059,
              "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": 679.88
            },
            {
              "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": 868.38
            },
            {
              "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": 365.42,
              "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": 900.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 679.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 689.41
            },
            {
              "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": 928.74
            },
            {
              "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": 773.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 773.07
            },
            {
              "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": 351.5,
              "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": 689.41
            },
            {
              "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": 289.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 669.29
            },
            {
              "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": 669.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 582.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 669.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 773.07
            },
            {
              "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": 365.42,
              "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": 355.12,
              "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": 348.02,
              "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": 877.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 868.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "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": 679.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "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": 900.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 669.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "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": 679.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 794.25
            },
            {
              "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": 856.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 582.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "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": 931.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 794.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 1059,
              "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": 900.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 689.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 582.45
            },
            {
              "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": 582.45
            },
            {
              "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": 1059,
              "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": 1059,
              "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": 679.88
            },
            {
              "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": 348.02,
              "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": 1059
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 868.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 679.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 868.38
            },
            {
              "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": 669.29
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 900.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 587.75
            },
            {
              "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": 679.88
            },
            {
              "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": 1059,
              "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": 669.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 794.25
            },
            {
              "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": 900.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1059,
              "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": 689.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 856.73
            },
            {
              "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": 355.12,
              "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": 582.45
            },
            {
              "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": 868.38
            },
            {
              "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": 351.5,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "L2036 Kafo Custom Plastic Double Upright Custom",
      "code_information": [
        {
          "code": "PX-27400088",
          "type": "CDM"
        },
        {
          "code": "L2036",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5960,
          "discounted_cash": 3874,
          "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": 3820.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3903.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3903.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "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": 4940.84
            },
            {
              "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": 4887.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4350.8
            },
            {
              "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": 5066
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3808.44
            },
            {
              "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": 3903.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4821.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3278
            },
            {
              "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": 3820.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5960
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5960,
              "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": 4887.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5960,
              "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": 3635.6
            },
            {
              "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": 5960,
              "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": 5226.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3278
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3820.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4887.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3808.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4940.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4940.84
            },
            {
              "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": 3820.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3820.36
            },
            {
              "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": 3820.36
            },
            {
              "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": 5226.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3820.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4470
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3903.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4350.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4470
            },
            {
              "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": 3820.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3808.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4887.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5960,
              "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": 3879.96
            },
            {
              "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": 3874
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4350.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3820.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4887.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3307.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4887.2
            },
            {
              "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": 3903.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3879.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4887.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4350.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3820.36
            },
            {
              "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": 3307.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "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": 3635.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3820.36
            },
            {
              "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": 5244.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3879.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4470
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3879.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3278
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4350.8
            },
            {
              "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": 3903.8
            },
            {
              "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": 4821.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3903.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3278
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3278
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3879.96
            },
            {
              "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": 4887.2
            },
            {
              "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": 3307.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3808.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3278
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5960,
              "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": 3635.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3903.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5066
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1627.08
            },
            {
              "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": 3307.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4350.8
            },
            {
              "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": 3278
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3820.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3635.6
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Mill Run",
      "code_information": [
        {
          "code": "PX-65900136",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 284.3,
          "discounted_cash": 184.79,
          "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": 182.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 230
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 233.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 185.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 179.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 241.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 213.23
            },
            {
              "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": 249.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 230
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 182.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 241.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 207.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 241.66
            },
            {
              "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": 182.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 284.3,
              "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": 207.54
            },
            {
              "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": 185.08
            },
            {
              "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": 182.52
            },
            {
              "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": 157.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 179.68
            },
            {
              "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": 233.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 233.13
            },
            {
              "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": 157.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 235.68
            },
            {
              "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": 284.3,
              "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": 179.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 182.52
            },
            {
              "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": 77.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 157.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 241.66
            },
            {
              "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": 235.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 241.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 207.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 241.66
            },
            {
              "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": 284.3,
              "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": 179.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 182.52
            },
            {
              "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": 157.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 182.52
            },
            {
              "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": 185.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 233.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 213.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 233.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 284.3,
              "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": 284.3,
              "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": 241.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 241.66
            },
            {
              "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": 241.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 182.52
            },
            {
              "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": 156.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 156.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 182.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 233.13
            },
            {
              "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": 182.52
            },
            {
              "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": 250.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 185.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 235.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 185.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 284.3,
              "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": 182.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 241.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 156.37
            },
            {
              "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": 207.54
            },
            {
              "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": 241.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 284.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 233.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 284.3,
              "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": 213.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 207.54
            },
            {
              "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": 182.52
            },
            {
              "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": 233.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 241.66
            },
            {
              "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": 249.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 207.54
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Kingston Ashland",
      "code_information": [
        {
          "code": "PX-65900164",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 270.73,
          "discounted_cash": 175.97,
          "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": 173.81
            },
            {
              "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": 150.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 224.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.81
            },
            {
              "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": 224.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.63
            },
            {
              "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": 173.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 270.73,
              "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": 224.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.9
            },
            {
              "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": 173.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 173.81
            },
            {
              "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": 171.1
            },
            {
              "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": 197.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 270.73,
              "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": 222
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.81
            },
            {
              "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": 176.25
            },
            {
              "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": 171.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 219.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 173.81
            },
            {
              "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": 148.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "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": 219.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 270.73,
              "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": 230.12
            },
            {
              "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": 237.43
            },
            {
              "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": 176.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.9
            },
            {
              "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": 150.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 171.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "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": 222
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 270.73,
              "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": 270.73,
              "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": 150.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "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": 270.73,
              "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": 270.73,
              "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": 203.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 270.73
            },
            {
              "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": 270.73,
              "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": 203.05
            },
            {
              "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": 73.91
            },
            {
              "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": 230.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 270.73,
              "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": 173.81
            },
            {
              "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": 222
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 203.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.63
            },
            {
              "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": 173.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.9
            },
            {
              "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": 237.43
            },
            {
              "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": 222
            },
            {
              "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": 270.73,
              "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": 148.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.63
            },
            {
              "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": 238.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 270.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Amputation of Toe; M J",
      "code_information": [
        {
          "code": "PX-51000116",
          "type": "CDM"
        },
        {
          "code": "28820",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4804,
          "discounted_cash": 3122.6,
          "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": 3084.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3939.28
            },
            {
              "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": 4213.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3036.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3084.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3127.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 4804,
              "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": 3982.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4804,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3084.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3127.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3127.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3939.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 4804,
              "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": 4804,
              "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": 2666.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3603
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2642.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 2642.2
            },
            {
              "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": 4083.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 3036.13
            },
            {
              "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": 4213.11
            },
            {
              "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": 3084.17
            },
            {
              "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": 3127.4
            },
            {
              "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": 3939.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4804
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3084.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3603
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3122.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3084.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3084.17
            },
            {
              "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": 3084.17
            },
            {
              "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": 3506.92
            },
            {
              "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": 2666.22
            },
            {
              "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": 2666.22
            },
            {
              "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": 4227.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 4083.4
            },
            {
              "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": 3939.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 4804,
              "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": 4804,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "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": 3084.17
            },
            {
              "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": 3036.13
            },
            {
              "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": 3127.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3939.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 2642.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "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": 3939.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2642.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 3982.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3506.92
            },
            {
              "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": 4804,
              "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": 4804,
              "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": 4804,
              "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": 3982.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3036.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3886.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 2666.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2642.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 4804,
              "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": 4083.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3506.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3506.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3603
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3036.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2642.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3506.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4804,
              "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": 4804,
              "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": 3084.17
            },
            {
              "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": 1311.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2642.2
            },
            {
              "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": 3886.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3036.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3939.28
            },
            {
              "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": 3036.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3506.92
            },
            {
              "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": 3084.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3084.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3939.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4083.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3036.13
            }
          ]
        }
      ]
    },
    {
      "description": "Heel & Elbow Protector Heelbo X Lrg Green Ea= 1 Pair",
      "code_information": [
        {
          "code": "PX-CHBH12040",
          "type": "CDM"
        },
        {
          "code": "E0191",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18.62,
          "discounted_cash": 12.1,
          "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": 11.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "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": 10.33
            },
            {
              "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": 11.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 15.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 13.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 10.24
            },
            {
              "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": 13.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 10.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 12.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "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": 15.27
            },
            {
              "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": 11.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.59
            },
            {
              "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": 11.95
            },
            {
              "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": 15.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 18.62,
              "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": 11.95
            },
            {
              "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": 16.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "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": 15.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 18.62,
              "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": 11.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.95
            },
            {
              "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": 11.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.95
            },
            {
              "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": 18.62,
              "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": 11.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 18.62,
              "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": 15.44
            },
            {
              "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": 16.39
            },
            {
              "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": 12.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 16.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.77
            },
            {
              "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": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 5.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 13.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.97
            },
            {
              "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": 15.83
            },
            {
              "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": 11.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "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": 10.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 15.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 15.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 15.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 11.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.62,
              "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": 15.83
            },
            {
              "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": 15.06
            }
          ]
        }
      ]
    },
    {
      "description": "Packing Strips Plain 1-4 in X 5 Yds Curity",
      "code_information": [
        {
          "code": "PX-CHKN7631",
          "type": "CDM"
        },
        {
          "code": "A6407",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.28,
          "discounted_cash": 3.43,
          "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": 3.39
            },
            {
              "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": 5.28,
              "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": 5.28,
              "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": 3.44
            },
            {
              "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": 4.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.85
            },
            {
              "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": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.28,
              "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": 5.28,
              "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": 4.49
            },
            {
              "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": 5.28,
              "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": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 5.28,
              "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": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 5.28,
              "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": 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": 3.39
            },
            {
              "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": 5.28,
              "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": 2.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "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": 3.34
            },
            {
              "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": 5.28,
              "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": 4.65
            },
            {
              "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": 3.85
            },
            {
              "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": 5.28,
              "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": 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": 2.93
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 4.38
            },
            {
              "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": 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": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 3.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.28,
              "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": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 4.49
            },
            {
              "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": 5.28,
              "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": 5.28,
              "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": 5.28,
              "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": 5.28,
              "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": 3.96
            },
            {
              "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": 3.44
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.28,
              "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": 5.28,
              "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": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "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": 3.44
            },
            {
              "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": 2.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 5.28,
              "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": 5.28,
              "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": 3.34
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.28,
              "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": 5.28,
              "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": 4.33
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.27
            },
            {
              "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": 5.28,
              "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": 5.28,
              "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": 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": "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": "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": "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": "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 MANSFIELD CITY SCHOOLS [485250]",
              "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.28,
              "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": 2.93
            },
            {
              "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": 4.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "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": "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 HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 4.33
            },
            {
              "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": 2.9
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 2.9
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 4.49
            },
            {
              "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": 5.28,
              "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": 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": 4.33
            },
            {
              "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": 4.33
            },
            {
              "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": "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": "AETNA [310]",
              "plan_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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.44
            },
            {
              "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": 5.28,
              "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": 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": 4.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.28,
              "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": 3.96
            },
            {
              "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": 4.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "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": 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": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.28,
              "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": 4.38
            }
          ]
        }
      ]
    },
    {
      "description": "Nutritional Isosource Hn 250ml",
      "code_information": [
        {
          "code": "PX-CHNES184500",
          "type": "CDM"
        },
        {
          "code": "B4150",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.17,
          "discounted_cash": 1.41,
          "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": 1.39
            },
            {
              "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": 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": 1.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "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": "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": "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": "HUMANA [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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.9
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.84
            },
            {
              "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": "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": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "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": 1.2
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "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 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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "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": 2.17,
              "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": 1.41
            },
            {
              "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": 1.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "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": 1.19
            },
            {
              "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": 1.2
            },
            {
              "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": "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": "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": "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/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": "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": "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": "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": "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": "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 OXFORD [625260]",
              "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": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "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": 1.91
            },
            {
              "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.8
            },
            {
              "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": 1.78
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.17,
              "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": 1.84
            },
            {
              "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": "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": "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 CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "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": "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": "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 HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "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": 1.37
            },
            {
              "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": 2.17,
              "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": 1.63
            },
            {
              "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 GEHA [625285]",
              "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 MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "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": 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": "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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 1.58
            },
            {
              "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": 2.17,
              "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": 1.41
            },
            {
              "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": 2.17,
              "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": 1.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.17
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            }
          ]
        }
      ]
    },
    {
      "description": "Clamp Straight Duolock Tail Closure",
      "code_information": [
        {
          "code": "PX-CHCV175635",
          "type": "CDM"
        },
        {
          "code": "A4363",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3,
          "discounted_cash": 1.95,
          "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": 1.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.46
            },
            {
              "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": 2.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 3,
              "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": 3,
              "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": 3,
              "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,
              "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": 1.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3,
              "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": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3,
              "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": 2.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.25
            },
            {
              "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": 1.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 2.19
            },
            {
              "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": 2.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            },
            {
              "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": 0.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.9
            },
            {
              "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": 1.9
            },
            {
              "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": 1.95
            },
            {
              "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": 2.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.43
            },
            {
              "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": 2.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.46
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.9
            },
            {
              "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": 2.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.95
            },
            {
              "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": 1.95
            },
            {
              "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": 1.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.19
            },
            {
              "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": 3,
              "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": 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": 1.93
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3,
              "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,
              "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": 2.19
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.67
            },
            {
              "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,
              "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": 2.55
            },
            {
              "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": 1.93
            },
            {
              "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,
              "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": 2.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.19
            },
            {
              "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": 3,
              "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": 3,
              "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": 1.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3,
              "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": 2.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3,
              "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,
              "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,
              "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": 2.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3,
              "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": 1.9
            },
            {
              "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": 2.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.46
            },
            {
              "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": 2.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 1.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3,
              "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": 2.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.93
            },
            {
              "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": 3,
              "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": 2.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.55
            }
          ]
        }
      ]
    },
    {
      "description": "Tubular Drsg Tubigrip Size F Lg Knees Med Thighs",
      "code_information": [
        {
          "code": "PX-CHSM1438",
          "type": "CDM"
        },
        {
          "code": "A6457",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 87.13,
          "discounted_cash": 56.63,
          "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": 55.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.07
            },
            {
              "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": 48.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 87.13,
              "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": 63.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.45
            },
            {
              "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": 87.13,
              "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": 87.13,
              "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": 87.13,
              "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": 47.92
            },
            {
              "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": 87.13,
              "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": 55.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.45
            },
            {
              "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": 87.13,
              "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": 87.13,
              "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": 87.13,
              "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": 71.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 87.13,
              "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": 74.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.45
            },
            {
              "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": 55.07
            },
            {
              "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": 55.94
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 87.13,
              "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": 76.41
            },
            {
              "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": 87.13,
              "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": 56.72
            },
            {
              "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": 48.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 87.13,
              "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": 87.13,
              "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": 72.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 48.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.94
            },
            {
              "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": 56.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 70.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.6
            },
            {
              "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": 87.13,
              "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": 87.13,
              "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": 87.13,
              "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": 87.13,
              "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": 47.92
            },
            {
              "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": 63.6
            },
            {
              "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": 87.13,
              "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": 74.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 87.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.92
            },
            {
              "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": 55.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "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": 55.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.07
            },
            {
              "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": 87.13,
              "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": 87.13,
              "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": 47.92
            },
            {
              "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": 87.13,
              "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": 56.72
            },
            {
              "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": 55.94
            },
            {
              "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": 71.45
            },
            {
              "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": 48.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "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": 55.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "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": 55.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.94
            },
            {
              "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": 70.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.45
            },
            {
              "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": 23.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "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": 76.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 87.13,
              "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": 65.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 87.13,
              "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": 87.13,
              "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": 87.13,
              "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": 87.13,
              "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": 63.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "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": 71.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.72
            },
            {
              "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": 87.13,
              "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": 87.13,
              "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": 55.94
            },
            {
              "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": 71.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 87.13,
              "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": 87.13,
              "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": 47.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.06
            },
            {
              "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": 87.13,
              "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": 87.13,
              "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": 87.13,
              "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": 74.06
            },
            {
              "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": 76.41
            },
            {
              "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": 87.13,
              "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": 72.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.07
            },
            {
              "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": 87.13,
              "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": 47.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 87.13,
              "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": 63.6
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 8.71,
          "discounted_cash": 5.66,
          "payers_information": [
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 5.59
            },
            {
              "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": 8.71,
              "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": 7.14
            },
            {
              "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": 7.64
            },
            {
              "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": 4.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 7.22
            },
            {
              "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": 8.71,
              "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": 7.05
            },
            {
              "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": 8.71,
              "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": 7.66
            },
            {
              "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": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 4.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "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": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 4.83
            },
            {
              "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": 8.71,
              "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": 7.4
            },
            {
              "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": 5.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "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": 5.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 5.67
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 7.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.67
            },
            {
              "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": 8.71,
              "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": 8.71,
              "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": 4.79
            },
            {
              "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": 4.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 7.14
            },
            {
              "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": 5.59
            },
            {
              "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": 8.71,
              "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": 7.14
            },
            {
              "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": 8.71,
              "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": 5.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "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": 7.64
            },
            {
              "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": 5.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 8.71,
              "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": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "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": 5.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "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": 2.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.36
            },
            {
              "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": 8.71,
              "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": 5.59
            },
            {
              "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": 7.14
            },
            {
              "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": 4.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 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": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 7.14
            },
            {
              "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": 5.5
            },
            {
              "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": 8.71,
              "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 TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "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": 8.71,
              "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": 7.4
            },
            {
              "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": 8.71,
              "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": 8.71,
              "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": 7.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 7.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "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": 7.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 6.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 7.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.71,
              "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": 8.71,
              "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": 4.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.36
            }
          ]
        }
      ]
    },
    {
      "description": "Thickener Thick-It 10 Oz Thickner",
      "code_information": [
        {
          "code": "PX-CHPXJ584",
          "type": "CDM"
        },
        {
          "code": "B4100",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.26,
          "discounted_cash": 6.02,
          "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": 5.94
            },
            {
              "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": 5.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 7.59
            },
            {
              "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": 9.26,
              "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": 7.87
            },
            {
              "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": 5.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.87
            },
            {
              "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": 9.26,
              "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": 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": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 5.85
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.26
            },
            {
              "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": 7.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 9.26,
              "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": 9.26,
              "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": 5.14
            },
            {
              "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": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 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": 5.85
            },
            {
              "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": 5.94
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 7.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.76
            },
            {
              "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": 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": 5.94
            },
            {
              "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": 5.14
            },
            {
              "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": 6.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 5.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 7.59
            },
            {
              "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": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 7.68
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 8.15
            },
            {
              "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": 6.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 9.26,
              "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": 9.26,
              "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": 5.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "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": 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": 7.59
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "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": 8.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 9.26,
              "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": 5.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.87
            },
            {
              "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": 9.26,
              "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": 7.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 5.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 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": 6.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.68
            },
            {
              "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": 6.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.95
            },
            {
              "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": 7.59
            },
            {
              "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": 9.26,
              "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": 7.87
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 7.49
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.87
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.26,
              "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": 9.26,
              "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": 7.87
            },
            {
              "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": 2.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.95
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Sponge Sterile Curity Amd 4 in X 4 in 12-Ply 2pack",
      "code_information": [
        {
          "code": "PX-CHKN2533",
          "type": "CDM"
        },
        {
          "code": "A6222",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.28,
          "discounted_cash": 0.18,
          "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": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.28,
              "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": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.28,
              "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": 0.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.23
            },
            {
              "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": 0.28,
              "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": 0.18
            },
            {
              "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": 0.28,
              "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": 0.28,
              "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": 0.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.24
            },
            {
              "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": 0.28,
              "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": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.23
            },
            {
              "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": 0.28,
              "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": 0.24
            },
            {
              "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": 0.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.15
            },
            {
              "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": 0.28,
              "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": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.25
            },
            {
              "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": 0.28,
              "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": 0.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.24
            },
            {
              "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": 0.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 0.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.18
            },
            {
              "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": 0.28,
              "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": 0.18
            },
            {
              "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": 0.18
            },
            {
              "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": 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": 0.28,
              "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": 0.25
            },
            {
              "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": 0.28,
              "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": 0.2
            },
            {
              "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": 0.28,
              "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": 0.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.24
            },
            {
              "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": 0.28,
              "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": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.18
            },
            {
              "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": 0.28,
              "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": 0.18
            },
            {
              "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": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.18
            },
            {
              "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": 0.28,
              "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": 0.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.23
            },
            {
              "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": 0.28,
              "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": 0.28,
              "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": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.24
            },
            {
              "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": 0.28,
              "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": 0.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.28,
              "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": 0.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.28,
              "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": 0.28,
              "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": 0.28,
              "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": 0.28,
              "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": 0.28,
              "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": 0.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.15
            },
            {
              "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": 0.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.23
            },
            {
              "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": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.18
            },
            {
              "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": 0.28,
              "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": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "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": 0.18
            },
            {
              "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": 0.18
            },
            {
              "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": 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": 0.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.24
            },
            {
              "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": 0.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed the Laurels of Walden Park",
      "code_information": [
        {
          "code": "PX-65900214",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 278.11,
          "discounted_cash": 180.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 278.11,
              "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": 208.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 181.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "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": 178.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.55
            },
            {
              "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": 154.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 208.58
            },
            {
              "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": 243.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.55
            },
            {
              "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": 152.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 181.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 230.55
            },
            {
              "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": 228.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 236.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 152.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 178.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.96
            },
            {
              "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": 244.74
            },
            {
              "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": 181.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 278.11,
              "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": 278.11,
              "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": 230.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "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": 181.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "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": 203.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.02
            },
            {
              "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": 243.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 236.39
            },
            {
              "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": 154.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 278.11,
              "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": 278.11,
              "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": 178.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 181.05
            },
            {
              "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": 175.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 224.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 236.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 230.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 278.11,
              "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": 175.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 75.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 224.99
            },
            {
              "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": 228.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 208.58
            },
            {
              "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": 154.35
            },
            {
              "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": 178.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 154.35
            },
            {
              "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": 175.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.02
            },
            {
              "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": 178.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.96
            },
            {
              "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": 236.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "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": 152.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 178.55
            },
            {
              "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": 228.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "\"1 Pc Ctf Cvx V1 Plateau Size 13-16\"\" to 1-11-16\"\" Drnable\"",
      "code_information": [
        {
          "code": "PX-CHCV421615",
          "type": "CDM"
        },
        {
          "code": "A4389",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.05,
          "discounted_cash": 7.83,
          "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": 7.74
            },
            {
              "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": 12.05,
              "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": 9.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.05,
              "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": 12.05,
              "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": 12.05,
              "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": 12.05,
              "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": 7.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 9.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 12.05,
              "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": 12.05,
              "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": 9.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.24
            },
            {
              "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": 12.05,
              "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": 7.74
            },
            {
              "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": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 10.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 12.05,
              "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": 10.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.8
            },
            {
              "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": 12.05,
              "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": 9.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.88
            },
            {
              "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": 8.8
            },
            {
              "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": 12.05,
              "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": 12.05,
              "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": 7.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 7.74
            },
            {
              "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": 10.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 7.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.75
            },
            {
              "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": 9.88
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.05,
              "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": 8.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.74
            },
            {
              "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": 7.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 10.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 9.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 12.05,
              "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": 12.05,
              "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": 12.05,
              "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": 7.84
            },
            {
              "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": 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": 7.62
            },
            {
              "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": 12.05,
              "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": 10.6
            },
            {
              "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": 12.05,
              "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": 7.74
            },
            {
              "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": 7.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.84
            },
            {
              "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": 12.05,
              "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": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 9.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 9.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.88
            },
            {
              "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": 12.05,
              "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": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 6.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 12.05,
              "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": 12.05,
              "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": 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": 9.75
            },
            {
              "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": 7.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.05,
              "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": 10.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.63
            },
            {
              "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": 12.05,
              "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": 10.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.05,
              "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": 7.74
            }
          ]
        }
      ]
    },
    {
      "description": "Lactic Acid Lactate",
      "code_information": [
        {
          "code": "PX-30101462",
          "type": "CDM"
        },
        {
          "code": "83605",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 79,
          "discounted_cash": 51.35,
          "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": 50.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 67.15
            },
            {
              "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": 67.15
            },
            {
              "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": 69.28
            },
            {
              "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": 51.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "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": 51.43
            },
            {
              "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": 21.57
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 69.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "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": 57.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "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": 49.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "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": 64.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 50.72
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 79,
              "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": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 50.72
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 51.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 51.43
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 43.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 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": 57.67
            },
            {
              "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": 64.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 50.72
            },
            {
              "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": 49.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 67.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 49.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 79,
              "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": 57.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "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": 51.43
            },
            {
              "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": 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": 59.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 49.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 50.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "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": 57.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 49.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.61,
              "estimated_amount": 15.61
            },
            {
              "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": 79,
              "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": 79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 79,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 79,
              "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": 67.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "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": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 69.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "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": 51.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "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": 43.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "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": 67.15
            },
            {
              "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": 69.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 64.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "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": 49.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 79,
              "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": 63.91
            },
            {
              "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": 64.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 43.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.57,
              "estimated_amount": 11.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 50.72
            },
            {
              "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": 63.91
            },
            {
              "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": 63.91
            },
            {
              "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": 64.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.15,
              "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": 49.93
            },
            {
              "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": 69.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "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": 21.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 43.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 49.93
            },
            {
              "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": 69.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.69,
              "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": 50.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.39,
              "estimated_amount": 43.39
            }
          ],
          "minimum": 11.57,
          "maximum": 43.39
        }
      ]
    },
    {
      "description": "\"Hydrofiber Drsg Ag Cover 3-12\"\" X 6\"\"\"",
      "code_information": [
        {
          "code": "PX-CHCV412010",
          "type": "CDM"
        },
        {
          "code": "A6197",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 75.51,
          "discounted_cash": 49.08,
          "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": 48.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.72
            },
            {
              "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": 47.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 75.51,
              "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": 75.51,
              "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": 75.51,
              "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": 75.51,
              "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": 47.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.92
            },
            {
              "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": 66.45
            },
            {
              "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": 75.51,
              "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": 48.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 75.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 62.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.6
            },
            {
              "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": 48.48
            },
            {
              "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": 49.16
            },
            {
              "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": 66.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 48.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.48
            },
            {
              "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": 61.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.72
            },
            {
              "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": 55.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.12
            },
            {
              "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": 75.51,
              "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": 41.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.48
            },
            {
              "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": 75.51,
              "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": 49.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 75.51,
              "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": 56.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.51,
              "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": 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": 55.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 66.22
            },
            {
              "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": 75.51,
              "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": 41.91
            },
            {
              "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": 41.53
            },
            {
              "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": 48.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.18
            },
            {
              "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": 41.91
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.51,
              "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": 64.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 47.72
            },
            {
              "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": 75.51,
              "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": 75.51,
              "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": 48.48
            },
            {
              "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": 61.92
            },
            {
              "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": 61.92
            },
            {
              "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": 61.92
            },
            {
              "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": 75.51,
              "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": 75.51,
              "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": 47.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 75.51,
              "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": 64.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 75.51,
              "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": 48.48
            },
            {
              "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": 64.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 41.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 75.51,
              "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": 64.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 75.51,
              "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": 41.53
            },
            {
              "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": 75.51,
              "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": 47.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.72
            },
            {
              "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": 75.51,
              "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": 64.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.51,
              "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": 49.16
            },
            {
              "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": 75.51,
              "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": 61.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.12
            },
            {
              "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": 75.51,
              "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": 75.51,
              "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": 64.2,
              "estimated_amount": 48.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.92
            },
            {
              "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": 20.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.18
            },
            {
              "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": 75.51,
              "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": 41.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.63
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 2 3-4 in New Image High Output",
      "code_information": [
        {
          "code": "PX-CHHO18014",
          "type": "CDM"
        },
        {
          "code": "A4412",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.53,
          "discounted_cash": 2.94,
          "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": 2.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.49
            },
            {
              "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": 4.53,
              "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": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 2.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.53,
              "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": 3.31
            },
            {
              "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": 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": 2.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 3.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 2.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 4.53,
              "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": 3.76
            },
            {
              "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": 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": 2.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.85
            },
            {
              "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": 4.53,
              "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": 4.53,
              "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": 2.86
            },
            {
              "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": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.86
            },
            {
              "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": 4.53,
              "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": 3.85
            },
            {
              "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": 4.53,
              "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": 3.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.49
            },
            {
              "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": 2.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 2.86
            },
            {
              "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": 2.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.95
            },
            {
              "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": 3.97
            },
            {
              "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": 3.31
            },
            {
              "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": 4.53,
              "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": 3.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.49
            },
            {
              "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": 4.53,
              "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": 2.51
            },
            {
              "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": 4.53,
              "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": 2.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.71
            },
            {
              "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": 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": 3.76
            },
            {
              "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": 4.53,
              "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": 4.53,
              "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": 4.53,
              "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": 2.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 3.85
            },
            {
              "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": 4.53,
              "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": 3.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.53,
              "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": 4.53,
              "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": 4.53,
              "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": 4.53,
              "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": 4.53,
              "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": 4.53,
              "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": 3.85
            },
            {
              "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": 2.51
            },
            {
              "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": 2.86
            },
            {
              "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": 2.91
            },
            {
              "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": 2.91
            },
            {
              "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": 2.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.49
            },
            {
              "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": 4.53,
              "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": 2.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 2.91
            },
            {
              "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": 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": 3.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.85
            },
            {
              "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": 2.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 3.71
            },
            {
              "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": 4.53,
              "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": 3.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.91
            },
            {
              "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": 4.53,
              "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": 4.53,
              "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": 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": 3.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 2.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "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": 4.53,
              "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": 4.53,
              "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": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.53,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Cvx 5-8 in- 2 1-8 in Premier",
      "code_information": [
        {
          "code": "PX-CHHO85711",
          "type": "CDM"
        },
        {
          "code": "A5057",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.82,
          "discounted_cash": 10.28,
          "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": 10.16
            },
            {
              "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": 10.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 10
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 13.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "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": 15.82,
              "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": 15.82,
              "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": 10.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "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": 15.82,
              "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": 8.78
            },
            {
              "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": 12.97
            },
            {
              "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": 13.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.82,
              "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": 13.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 12.97
            },
            {
              "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": 15.82,
              "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": 10
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 8.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 8.7
            },
            {
              "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": 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": 11.55
            },
            {
              "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": 15.82,
              "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": 13.45
            },
            {
              "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": 15.82,
              "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
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "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": 4.32
            },
            {
              "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": 15.82,
              "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": 15.82,
              "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": 15.82,
              "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": 15.82,
              "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": 13.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 11.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 8.78
            },
            {
              "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": 8.7
            },
            {
              "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": 10.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 11.87
            },
            {
              "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": 13.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "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": 15.82,
              "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": 15.82,
              "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": 10.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.78
            },
            {
              "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": 15.82,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 13.11
            },
            {
              "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": 13.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "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": 10.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "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": 13.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 8.7
            },
            {
              "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": 15.82,
              "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": 15.82,
              "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": 10.16
            },
            {
              "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": 10.16
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.3
            },
            {
              "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": 12.8
            },
            {
              "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": 15.82,
              "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": 15.82,
              "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": 10.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "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": 11.55
            }
          ]
        }
      ]
    },
    {
      "description": "Wound Solution Vashe 4 Oz Antimicrobial",
      "code_information": [
        {
          "code": "PX-CHEL00312",
          "type": "CDM"
        },
        {
          "code": "A6260",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.82,
          "discounted_cash": 10.28,
          "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": 10.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 8.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "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": 8.78
            },
            {
              "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": 15.82,
              "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": 13.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 15.82,
              "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": 15.82,
              "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": 10.3
            },
            {
              "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": 12.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "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": 15.82,
              "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": 13.11
            },
            {
              "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": 10
            },
            {
              "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": 15.82,
              "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": 11.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.82,
              "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": 10
            },
            {
              "payer_name": "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
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.3
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 13.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 11.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.82,
              "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": 11.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "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": 15.82,
              "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": 10
            },
            {
              "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
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 13.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 10.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "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": 15.82,
              "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": 15.82,
              "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": 15.82,
              "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": 10.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 12.97
            },
            {
              "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": 10.16
            },
            {
              "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": 10.16
            },
            {
              "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": 10.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 8.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "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": 10.16
            },
            {
              "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": 12.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 13.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.55
            },
            {
              "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": 13.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "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": 13.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 15.82,
              "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": 13.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.97
            },
            {
              "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": 4.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.45
            },
            {
              "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": 8.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.82,
              "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": 12.97
            },
            {
              "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": 10.16
            },
            {
              "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": 8.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.7
            },
            {
              "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": 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": 15.82,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC General Health Panel",
      "code_information": [
        {
          "code": "PX-30100003",
          "type": "CDM"
        },
        {
          "code": "80050",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 219,
          "discounted_cash": 142.35,
          "minimum": 30.15,
          "maximum": 152.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "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
            },
            {
              "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": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            },
            {
              "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": 179.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 219,
              "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": 45,
              "estimated_amount": 98.55
            },
            {
              "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": 98.55
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "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": 179.58
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "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": 54.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.15,
              "estimated_amount": 30.15
            },
            {
              "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": 98.55
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "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": 98.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 98.55
            },
            {
              "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": 142.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 219,
              "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": 186.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "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 CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.15,
              "estimated_amount": 30.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.15,
              "estimated_amount": 30.15
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 98.55
            },
            {
              "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": "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            },
            {
              "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": "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": "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": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "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": 179.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "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": 192.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            },
            {
              "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": 120.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.87
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "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": 219,
              "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": 186.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 219,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.15,
              "estimated_amount": 30.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "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": 186.15
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 98.55
            },
            {
              "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": 159.87
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 164.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.48,
              "estimated_amount": 152.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 219,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "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": 109.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.58,
              "estimated_amount": 72.58
            },
            {
              "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": 109.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 109.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Oxygen Addl 15 Min",
      "code_information": [
        {
          "code": "PX-27100007",
          "type": "CDM"
        },
        {
          "code": "27100007",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13,
          "discounted_cash": 8.45,
          "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": 8.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.66
            },
            {
              "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": 8.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.46
            },
            {
              "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": 9.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 9.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "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": 7.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "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": 11.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.49
            },
            {
              "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": 13,
              "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": 11.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.44
            },
            {
              "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": 8.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "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": 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": 10.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.66
            },
            {
              "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": 10.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "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": 9.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 10.66
            },
            {
              "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": 11.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.15
            },
            {
              "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": 3.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "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": 11.4
            },
            {
              "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": 8.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.22
            },
            {
              "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": 8.16
            },
            {
              "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": 13,
              "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": 11.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13,
              "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": 8.22
            },
            {
              "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": 8.35
            },
            {
              "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": 10.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.22
            },
            {
              "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": 8.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.49
            },
            {
              "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": 7.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.35
            },
            {
              "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": 10.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.44
            },
            {
              "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": 13,
              "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": 8.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.46
            },
            {
              "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": 8.22
            },
            {
              "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": 8.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.15
            },
            {
              "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": 11.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "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": 8.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 7.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "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": 13,
              "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": 10.66
            },
            {
              "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": 7.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.78
            },
            {
              "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": 10.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.16
            },
            {
              "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": 11.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.05
            },
            {
              "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": 7.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.35
            },
            {
              "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": 8.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Elbow Immobilizer",
      "code_information": [
        {
          "code": "PX-27100022",
          "type": "CDM"
        },
        {
          "code": "27100022",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29,
          "discounted_cash": 18.85,
          "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": 18.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 18.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 15.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 18.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 23.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 18.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "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": 24.65
            },
            {
              "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": 18.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 18.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29,
              "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": 24.65
            },
            {
              "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,
              "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": 25.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 18.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 18.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 18.59
            },
            {
              "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": 25.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 18.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 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": 21.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.95
            },
            {
              "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": 29,
              "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": 17.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            },
            {
              "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": 16.1
            },
            {
              "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": 24.04
            },
            {
              "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": 16.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.88
            },
            {
              "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": 18.59
            },
            {
              "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": 18.59
            },
            {
              "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": 18.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.78
            },
            {
              "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": 23.46
            },
            {
              "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": 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": 25.52
            },
            {
              "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": 16.1
            },
            {
              "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": 29,
              "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": 18.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 18.59
            },
            {
              "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": 7.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 18.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 18.53
            },
            {
              "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": 64.1,
              "estimated_amount": 18.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.04
            },
            {
              "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": 29,
              "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": 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": 19
            },
            {
              "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": 17.69
            },
            {
              "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": 18.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.65
            }
          ]
        }
      ]
    },
    {
      "description": "Nutritional Boost Vanilla 8oz",
      "code_information": [
        {
          "code": "PX-CH-BUR-67439",
          "type": "CDM"
        },
        {
          "code": "B4150",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.33,
          "discounted_cash": 1.51,
          "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": 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": 1.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 1.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 1.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 2.33,
              "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": 1.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 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": 1.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.7
            },
            {
              "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": 1.98
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 1.5
            },
            {
              "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": 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": 1.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 1.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.33
            },
            {
              "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": 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": 1.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.33,
              "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": 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": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.52
            },
            {
              "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": 2.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 1.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 2.33,
              "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": 1.91
            },
            {
              "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": 1.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.47
            },
            {
              "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": 2.33,
              "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": 1.88
            },
            {
              "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": 1.98
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.75
            },
            {
              "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": 2.33,
              "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": 1.47
            },
            {
              "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": 1.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.28
            },
            {
              "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": 2.33,
              "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": 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": 1.47
            },
            {
              "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": 2.33,
              "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": 2.33,
              "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": 1.5
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 2.33,
              "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": 1.47
            },
            {
              "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": 1.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.75
            },
            {
              "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": 2.04
            },
            {
              "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": 1.29
            },
            {
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 2.33,
              "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": 1.5
            },
            {
              "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": 1.29
            },
            {
              "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": 2.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.33,
              "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": 1.7
            },
            {
              "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": 1.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.98
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 1.91
            },
            {
              "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": 1.47
            },
            {
              "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": 2.33,
              "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": 1.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.98
            },
            {
              "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": 1.91
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsed Calcium Total",
      "code_information": [
        {
          "code": "PX-30101228",
          "type": "CDM"
        },
        {
          "code": "82310",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "minimum": 4.43,
          "maximum": 19.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "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 UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "estimated_amount": 4.43
            },
            {
              "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": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.53,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "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": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "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": 4.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "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": 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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": 4.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": 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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.53,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "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 BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "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": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": 4.05
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.42,
              "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": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": 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": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": 5.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "MOLINA 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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "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": 6.75
            },
            {
              "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 [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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 OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "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": 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": 7.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "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": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": 9,
              "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": 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": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "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": 4.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 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": 9,
              "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": 7.38
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.53,
              "estimated_amount": 7.53
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsed Cbc Without Diff",
      "code_information": [
        {
          "code": "PX-30500133",
          "type": "CDM"
        },
        {
          "code": "85027",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 28,
          "discounted_cash": 18.2,
          "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": 17.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.46,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.98
            },
            {
              "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": 17.7
            },
            {
              "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": 17.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "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": 15.54
            },
            {
              "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": 15.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "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": 18.23
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.98
            },
            {
              "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": 17.98
            },
            {
              "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": 17.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.79,
              "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": 20.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.44
            },
            {
              "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": 17.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "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": 7.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 23.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.7
            },
            {
              "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": 22.96
            },
            {
              "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": 22.96
            },
            {
              "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": 18.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.46,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "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": 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": 23.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 23.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.53,
              "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": 22.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.79,
              "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": 22.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.96
            },
            {
              "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": 24.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "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": 23.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 23.8
            },
            {
              "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": 22.96
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 6.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "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": 17.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 23.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "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": 17.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "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": 15.54
            },
            {
              "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": 24.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "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": 18.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.46,
              "estimated_amount": 9.46
            },
            {
              "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": 24.64
            },
            {
              "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": 28,
              "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": 18.23
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.47,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.54
            },
            {
              "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": 15.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.44
            },
            {
              "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": 28,
              "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": 17.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            },
            {
              "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": 17.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.26,
              "estimated_amount": 24.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.8
            }
          ],
          "minimum": 6.47,
          "maximum": 24.26
        }
      ]
    },
    {
      "description": "HC Needle Seed Implant",
      "code_information": [
        {
          "code": "PX-27200184",
          "type": "CDM"
        },
        {
          "code": "C1715",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34,
          "discounted_cash": 22.1,
          "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": 21.83
            },
            {
              "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": 18.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 34
            },
            {
              "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": 34,
              "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": 21.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "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": 21.83
            },
            {
              "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": 21.83
            },
            {
              "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": 34,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.82
            },
            {
              "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": 29.82
            },
            {
              "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": 34,
              "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": 24.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "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": 18.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.82
            },
            {
              "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": 21.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.88
            },
            {
              "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": 21.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.13
            },
            {
              "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": 29.82
            },
            {
              "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": 27.88
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "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": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "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": 24.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "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": 22.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "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": 27.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.88
            },
            {
              "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": 34,
              "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": 28.9
            },
            {
              "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": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "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": 18.7
            },
            {
              "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": 28.9
            },
            {
              "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": 34,
              "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": 27.88
            },
            {
              "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": 22.13
            },
            {
              "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": 22.13
            },
            {
              "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": 27.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "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": 34,
              "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": 34,
              "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": 27.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "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": 28.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "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": 22.1
            },
            {
              "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": 21.83
            },
            {
              "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": 21.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.5
            },
            {
              "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": 34,
              "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": 34,
              "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": 18.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 29.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.83
            },
            {
              "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": 27.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.87
            },
            {
              "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": 28.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 34,
              "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": 34,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.87
            },
            {
              "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": 18.87
            },
            {
              "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": 24.82
            },
            {
              "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": 9.28
            }
          ]
        }
      ]
    },
    {
      "description": "Packing Strips Plain 2 in X 5 Yds",
      "code_information": [
        {
          "code": "PX-CH-DUM59420",
          "type": "CDM"
        },
        {
          "code": "A6407",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.81,
          "discounted_cash": 3.13,
          "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": 3.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 3.51
            },
            {
              "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": 3.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.65
            },
            {
              "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": 3.51
            },
            {
              "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": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.04
            },
            {
              "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": 4.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.81,
              "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": 4.81,
              "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": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.81,
              "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": 3.94
            },
            {
              "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": 4.81,
              "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": 4.81,
              "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": 4.81,
              "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": 4.81,
              "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": 3.09
            },
            {
              "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": 3.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 2.67
            },
            {
              "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": 2.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.65
            },
            {
              "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": 3.09
            },
            {
              "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": 3.89
            },
            {
              "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": 3.09
            },
            {
              "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": 3.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 3.61
            },
            {
              "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": 4.81,
              "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": 4.09
            },
            {
              "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": 4.09
            },
            {
              "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": 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": 3.13
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.81,
              "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": 4.81,
              "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": 4.81,
              "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": 3.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 4.81,
              "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": 4.81,
              "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": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 2.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.13
            },
            {
              "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": 4.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.81,
              "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": 4.81,
              "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": 3.04
            },
            {
              "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": 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": 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": 3.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.51
            },
            {
              "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": 4.81,
              "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": 3.09
            },
            {
              "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": 3.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 3.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.61
            },
            {
              "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": 3.09
            },
            {
              "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": 4.81,
              "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": 3.51
            },
            {
              "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": 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": 4.09
            },
            {
              "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": 4.81,
              "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": 2.67
            },
            {
              "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": 4.81,
              "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": 2.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.81,
              "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": 2.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.09
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.65
            },
            {
              "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": 4.81,
              "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": 3.04
            },
            {
              "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": 1.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.09
            },
            {
              "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": 4.81,
              "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": 4.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.81,
              "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": 4.81,
              "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": 4.81,
              "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": 3.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "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
            }
          ]
        }
      ]
    },
    {
      "description": "Moisture Barrier Cream Baza-Pro 5 Oz",
      "code_information": [
        {
          "code": "PX-CH-SW1880",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.28,
          "discounted_cash": 9.93,
          "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": 9.81
            },
            {
              "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": 12.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.66
            },
            {
              "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": 9.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.81
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.4
            },
            {
              "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": 15.28,
              "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": 15.28,
              "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": 15.28,
              "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": 12.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.95
            },
            {
              "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": 12.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.53
            },
            {
              "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": 15.28,
              "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": 9.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.99
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 12.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.46
            },
            {
              "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": 9.81
            },
            {
              "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": 9.95
            },
            {
              "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": 12.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.48
            },
            {
              "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": 8.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 9.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.53
            },
            {
              "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": 8.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 9.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 8.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 15.28,
              "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": 12.99
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.99
            },
            {
              "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": 8.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.28,
              "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": 8.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.15
            },
            {
              "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": 4.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.15
            },
            {
              "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": 15.28,
              "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": 8.48
            },
            {
              "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": 15.28,
              "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": 9.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 15.28,
              "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": 12.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 9.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 15.28,
              "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": 9.81
            },
            {
              "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": 15.28,
              "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": 12.53
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 12.99
            },
            {
              "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": 12.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.28
            },
            {
              "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": 12.67
            },
            {
              "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": 9.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 8.4
            },
            {
              "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": 9.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 15.28,
              "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": 13.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 9.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 12.99
            },
            {
              "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": 11.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.28,
              "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": 15.28,
              "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": 9.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC Splint Finger Pip Dip Custom",
      "code_information": [
        {
          "code": "PX-27400004",
          "type": "CDM"
        },
        {
          "code": "L3933",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 624,
          "discounted_cash": 405.6,
          "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": 399.98
            },
            {
              "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": 504.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 455.52
            },
            {
              "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": 408.72
            },
            {
              "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": 517.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 406.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 511.68
            },
            {
              "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": 530.4
            },
            {
              "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": 624,
              "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": 517.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 511.68
            },
            {
              "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": 511.68
            },
            {
              "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": 624,
              "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": 468
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 408.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 343.2
            },
            {
              "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": 346.32
            },
            {
              "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": 624,
              "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": 399.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 346.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 398.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 406.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 399.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            },
            {
              "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": 408.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 399.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 399.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 455.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 511.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 408.72
            },
            {
              "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": 380.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 399.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "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": 624,
              "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": 530.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 343.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 399.98
            },
            {
              "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": 511.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "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": 405.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "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": 406.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 398.74
            },
            {
              "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": 549.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 343.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 504.82
            },
            {
              "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": 346.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 624,
              "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": 530.4
            },
            {
              "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": 170.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 399.98
            },
            {
              "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": 406.22
            },
            {
              "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": 343.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 624
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 468
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 398.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 406.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 468
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 455.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 511.68
            },
            {
              "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": 547.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 408.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 398.74
            },
            {
              "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": 346.32
            },
            {
              "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": 547.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "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": 399.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 399.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 408.72
            },
            {
              "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": 408.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 343.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            },
            {
              "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": 399.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 343.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 408.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 455.52
            },
            {
              "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": 455.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 517.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 511.68
            },
            {
              "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": 530.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 343.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 455.52
            },
            {
              "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": 511.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 380.64
            },
            {
              "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": 399.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 530.4
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Heavy Absorbency Small Cardinal",
      "code_information": [
        {
          "code": "PX-CH-IMCBPHS200",
          "type": "CDM"
        },
        {
          "code": "T4521",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.48,
          "discounted_cash": 0.31,
          "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": 0.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.35
            },
            {
              "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": 0.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.3
            },
            {
              "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": 0.48,
              "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": 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": 0.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.41
            },
            {
              "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": 0.48,
              "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": 0.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.41
            },
            {
              "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": 0.31
            },
            {
              "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": 0.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.48,
              "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": 0.35
            },
            {
              "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": 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": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.27
            },
            {
              "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": 0.48,
              "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": 0.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.48,
              "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": 0.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.48,
              "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": 0.48,
              "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": 0.48,
              "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": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.4
            },
            {
              "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": 0.48,
              "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": 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": 0.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.39
            },
            {
              "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": 0.39
            },
            {
              "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": 0.13
            },
            {
              "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": 0.48,
              "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": 0.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.48,
              "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": 0.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.48,
              "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": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.26
            },
            {
              "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": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.31
            },
            {
              "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": 0.31
            },
            {
              "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": 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": 0.31
            },
            {
              "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": 0.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.26
            },
            {
              "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": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.48,
              "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": 0.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.48,
              "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": 0.48,
              "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": 0.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.35
            },
            {
              "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": 0.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.36
            }
          ]
        }
      ]
    },
    {
      "description": "HC Splint Whfo Rigid WO Jnts Custom",
      "code_information": [
        {
          "code": "PX-27400046",
          "type": "CDM"
        },
        {
          "code": "L3808",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1041,
          "discounted_cash": 676.65,
          "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": 667.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 667.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 681.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 665.2
            },
            {
              "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": 1041,
              "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": 665.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 759.93
            },
            {
              "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": 759.93
            },
            {
              "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": 912.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 681.86
            },
            {
              "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": 1041,
              "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": 667.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 842.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 572.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 572.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 572.55
            },
            {
              "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": 862.99
            },
            {
              "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": 667.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 862.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 780.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 572.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 677.69
            },
            {
              "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": 853.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 853.62
            },
            {
              "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": 677.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "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": 912.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 667.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 577.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 665.2
            },
            {
              "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": 853.62
            },
            {
              "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": 677.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 853.62
            },
            {
              "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": 635.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 667.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 572.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1041,
              "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": 667.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 853.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 667.28
            },
            {
              "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": 842.17
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "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": 681.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "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": 667.28
            },
            {
              "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": 667.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 681.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "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": 1041,
              "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": 572.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 853.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "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": 284.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1041
            },
            {
              "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": 681.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 759.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 677.69
            },
            {
              "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": 681.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "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": 853.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 759.93
            },
            {
              "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": 1041,
              "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": 677.69
            },
            {
              "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": 577.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 780.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 681.86
            },
            {
              "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": 572.55
            },
            {
              "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": 676.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 884.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 667.28
            },
            {
              "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": 884.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 681.86
            },
            {
              "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": 916.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 667.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 853.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 759.93
            },
            {
              "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": 577.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 635.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 665.2
            },
            {
              "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": 577.76
            },
            {
              "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": 884.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 862.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 780.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 759.93
            }
          ]
        }
      ]
    },
    {
      "description": "Splint Ewhfo Rigid W/O Jnts Cust0m",
      "code_information": [
        {
          "code": "PX-27400057",
          "type": "CDM"
        },
        {
          "code": "L3765",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3750,
          "discounted_cash": 2437.5,
          "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": 2403.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2456.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2396.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2403.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2081.25
            },
            {
              "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": 2081.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2737.5
            },
            {
              "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": 3075
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3075
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3075
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2081.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2062.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2456.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "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": 1023.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2456.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3075
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "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": 2437.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2062.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2403.75
            },
            {
              "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": 2456.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2062.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2737.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3075
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2737.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2403.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2441.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2737.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "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": 3108.75
            },
            {
              "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": 2403.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3033.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2062.5
            },
            {
              "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": 2456.25
            },
            {
              "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": 2737.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2403.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2403.75
            },
            {
              "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": 3033.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2441.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2062.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2456.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3750,
              "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": 3750,
              "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": 2396.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "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": 2403.75
            },
            {
              "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": 2287.5
            },
            {
              "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": 3187.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2456.25
            },
            {
              "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": 2081.25
            },
            {
              "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": 3288.75
            },
            {
              "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": 3288.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "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": 2403.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2403.75
            },
            {
              "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": 3075
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "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": 2456.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2441.25
            },
            {
              "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": 3750,
              "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": 3187.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2812.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3108.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3750
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3108.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2812.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2062.5
            },
            {
              "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": 3750,
              "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": 2403.75
            },
            {
              "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": 2441.25
            },
            {
              "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": 3300
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2287.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2396.25
            },
            {
              "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": 2441.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3187.5
            },
            {
              "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": 2403.75
            },
            {
              "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": 3187.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3075
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2062.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2737.5
            },
            {
              "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": 3075
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2812.5
            },
            {
              "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": 3750,
              "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": 2396.25
            }
          ]
        }
      ]
    },
    {
      "description": "Collar Cervical Off the Shelf",
      "code_information": [
        {
          "code": "PX-27400069",
          "type": "CDM"
        },
        {
          "code": "L0120",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 204,
          "discounted_cash": 132.6,
          "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": 130.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "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": 133.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 112.2
            },
            {
              "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": 130.76
            },
            {
              "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": 179.52
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 165.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 167.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "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": 64.1,
              "estimated_amount": 130.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 130.76
            },
            {
              "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": 130.76
            },
            {
              "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 AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS 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": 169.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 132.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "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": 204,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 167.28
            },
            {
              "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": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 113.22
            },
            {
              "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": 113.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 130.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 153
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 132.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 167.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 153
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 133.62
            },
            {
              "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": 178.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 132.8
            },
            {
              "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": 204,
              "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": 133.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 130.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 153
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 31.43,
              "additional_payer_notes": "DMEPOS 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": 204,
              "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": 204
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 165.04
            },
            {
              "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": 55.69
            },
            {
              "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": 148.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 113.22
            },
            {
              "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": 178.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 130.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "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": 130.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 169.12
            },
            {
              "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": 204,
              "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": 133.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 204,
              "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": 130.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.92
            },
            {
              "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": 133.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "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": 133.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 130.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 130.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 112.2
            },
            {
              "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": 167.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 173.4
            },
            {
              "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": 169.12
            },
            {
              "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": 132.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 133.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "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": 113.22
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 130.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 112.2
            },
            {
              "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": 173.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 124.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 132.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 167.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 204,
              "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": 148.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 130.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 132.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 130.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 167.28
            },
            {
              "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": 167.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 173.4
            },
            {
              "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": 167.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.92
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 133.62
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 124.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 130.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.92
            },
            {
              "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
            }
          ],
          "minimum": 31.12,
          "maximum": 31.12
        }
      ]
    },
    {
      "description": "HC Procainamide So",
      "code_information": [
        {
          "code": "PX-30100036",
          "type": "CDM"
        },
        {
          "code": "80192",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 148,
          "discounted_cash": 96.2,
          "minimum": 14.36,
          "maximum": 62.81,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.92,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.92,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 148
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "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": 130.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.59,
              "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": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "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": 148,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "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": 125.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.7,
              "estimated_amount": 19.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "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": 148,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.85,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.36,
              "estimated_amount": 14.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.85,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.92,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.36,
              "estimated_amount": 14.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.92,
              "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": 96.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.92,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.36,
              "estimated_amount": 14.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.36,
              "estimated_amount": 14.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "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": 108.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "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": 121.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.04
            },
            {
              "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": 125.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "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": 121.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.7,
              "estimated_amount": 19.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.36
            },
            {
              "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": 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": 81.4
            },
            {
              "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": 121.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.85,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.75,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.48,
              "estimated_amount": 39.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.75,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 148,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.81,
              "estimated_amount": 62.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.73,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.8
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch Closed Esteem Synergy Medium",
      "code_information": [
        {
          "code": "PX-CH-CV4167-79",
          "type": "CDM"
        },
        {
          "code": "A4419",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.95,
          "discounted_cash": 1.92,
          "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": 1.89
            },
            {
              "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": 1.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.92
            },
            {
              "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": 2.95,
              "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": 1.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 2.95,
              "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": 2.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 2.21
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 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": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 2.95,
              "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": 2.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.42
            },
            {
              "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": 2.95,
              "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": 2.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 2.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.42
            },
            {
              "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": 2.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.42
            },
            {
              "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": 1.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.86
            },
            {
              "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": 2.95,
              "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": 2.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.95,
              "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": 1.89
            },
            {
              "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": 1.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "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": 2.59
            },
            {
              "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": 2.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 1.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.62
            },
            {
              "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": 2.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 2.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 2.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.64
            },
            {
              "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": 2.39
            },
            {
              "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": 1.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "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": 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": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 1.62
            },
            {
              "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": 1.62
            },
            {
              "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": 1.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "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": 1.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.62
            },
            {
              "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": 1.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.95,
              "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": 2.51
            },
            {
              "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": 1.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 2.95,
              "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": 2.95,
              "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": 2.95,
              "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": 2.95,
              "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": 2.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.95,
              "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": 1.64
            },
            {
              "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": 1.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 2.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hla Typing 1 Allele Hr So",
      "code_information": [
        {
          "code": "PX-30100104",
          "type": "CDM"
        },
        {
          "code": "81381",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 472,
          "discounted_cash": 306.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 295
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 387.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "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": 401.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 288.75,
              "estimated_amount": 288.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 354
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 344.56
            },
            {
              "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": 387.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 259.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 178.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 472,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 295
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 387.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "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": 259.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 259.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 472,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 171.6,
              "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": 387.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 295
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 118.05,
              "estimated_amount": 118.05
            },
            {
              "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": 472,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 112.51,
              "estimated_amount": 112.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 259.6
            },
            {
              "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": 401.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 387.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 387.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 387.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 344.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 178.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "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": 295
            },
            {
              "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": 295
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 171.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 171.6,
              "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": 401.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 288.75,
              "estimated_amount": 288.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 472,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "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": 236
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 112.51,
              "estimated_amount": 112.51
            },
            {
              "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": 344.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 112.51,
              "estimated_amount": 112.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 171.6,
              "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": 401.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 118.05,
              "estimated_amount": 118.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 295
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 259.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 354
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 354
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 171.6,
              "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": 62.5,
              "estimated_amount": 295
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 344.56
            },
            {
              "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": 472,
              "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": 472,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 472,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": 236
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 344.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 344.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 118.05,
              "estimated_amount": 118.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 295
            },
            {
              "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": 295
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 118.05,
              "estimated_amount": 118.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 472
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 401.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 295
            },
            {
              "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": 118
            },
            {
              "payer_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": 295
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 387.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "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": 415.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 295
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 259.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 169.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 178.4,
              "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": 259.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 472,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 637.13,
              "estimated_amount": 637.13
            },
            {
              "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": 306.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 169.9,
              "estimated_amount": 169.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 236
            }
          ],
          "minimum": 112.51,
          "maximum": 637.13
        }
      ]
    },
    {
      "description": "Acylcarnitines Quantitative Sendout",
      "code_information": [
        {
          "code": "PX-30100119",
          "type": "CDM"
        },
        {
          "code": "82017",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 195,
          "discounted_cash": 126.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 126.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 142.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 195,
              "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": 123.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 126.95
            },
            {
              "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": 157.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "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": 125.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.19
            },
            {
              "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": 159.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 146.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 108.23
            },
            {
              "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": 53.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 126.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.24
            },
            {
              "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": 171.02
            },
            {
              "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": 107.25
            },
            {
              "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": 159.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 161.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "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": 159.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 157.76
            },
            {
              "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": 123.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 165.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "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": 165.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 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": 125.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 126.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "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": 171.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 142.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 142.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.19
            },
            {
              "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": 108.23
            },
            {
              "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": 123.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 146.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 142.35
            },
            {
              "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": 195,
              "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": 125.19
            },
            {
              "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": 171.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 161.66
            },
            {
              "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": 142.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 123.24
            },
            {
              "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": 125.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 146.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 123.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.25
            },
            {
              "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": 108.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 142.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 125.19
            },
            {
              "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": 161.66
            },
            {
              "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": 126.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 165.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.25
            },
            {
              "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": 195,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 195
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 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": 108.23
            },
            {
              "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": 126.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 107.25
            },
            {
              "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": 125.19
            }
          ],
          "minimum": 24,
          "maximum": 63.26
        }
      ]
    },
    {
      "description": "HC Acth",
      "code_information": [
        {
          "code": "PX-30100120",
          "type": "CDM"
        },
        {
          "code": "82024",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 117,
          "discounted_cash": 76.05,
          "minimum": 33.12,
          "maximum": 144.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 40.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.12,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.62,
              "estimated_amount": 38.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.12,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "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": 95.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.62,
              "estimated_amount": 38.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "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": 102.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.35
            },
            {
              "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": 99.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 40.55,
              "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": 38.62,
              "estimated_amount": 38.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 87.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.12,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "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": 95.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 87.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.62,
              "estimated_amount": 38.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "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": 117,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 87.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.94
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 40.55,
              "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": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "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": 95.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.62,
              "estimated_amount": 38.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "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": 85.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 38.62,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.12,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.44,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "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": 52.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "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": 117,
              "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": 117
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.62,
              "estimated_amount": 38.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.62,
              "estimated_amount": 38.62
            },
            {
              "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": 29.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "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": 76.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "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": 64.35
            },
            {
              "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": 99.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 52.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.41
            },
            {
              "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": 117,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.44,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "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": 58.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.88,
              "estimated_amount": 46.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 95.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "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": 52.65
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.44,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "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": 58.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.83,
              "estimated_amount": 144.83
            }
          ]
        }
      ]
    },
    {
      "description": "Apolipoprotein a 1 Sendout",
      "code_information": [
        {
          "code": "PX-30100149",
          "type": "CDM"
        },
        {
          "code": "82172",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 94,
          "discounted_cash": 61.1,
          "minimum": 13.33,
          "maximum": 79.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "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": 94,
              "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": 70.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.09,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "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": 47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "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": 42.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.64,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.66,
              "estimated_amount": 14.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.64,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "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": 79.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "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": 94,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.09,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.14,
              "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": 21.09,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "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": 51.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.09,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "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": 47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 42.3
            },
            {
              "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": 68.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.3,
              "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": 45,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 42.3
            },
            {
              "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": 77.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.09,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.66,
              "estimated_amount": 14.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "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": 94,
              "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": 47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "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": 77.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "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": 42.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.66,
              "estimated_amount": 14.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.64,
              "estimated_amount": 22.64
            },
            {
              "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": 79.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "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": 23.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "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": 79.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.09,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.3,
              "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": 50,
              "estimated_amount": 47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "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": 77.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.3,
              "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": 82.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 47
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 21.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.66,
              "estimated_amount": 14.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.09,
              "estimated_amount": 21.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.33,
              "estimated_amount": 13.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.09,
              "estimated_amount": 79.09
            },
            {
              "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": 61.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 47
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cortisol Free by Dialysis",
      "code_information": [
        {
          "code": "PX-30100198",
          "type": "CDM"
        },
        {
          "code": "82530",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 301,
          "discounted_cash": 195.65,
          "minimum": 14.33,
          "maximum": 62.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "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": 195.65
            },
            {
              "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": 264.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 246.82
            },
            {
              "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": 219.73
            },
            {
              "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": 301,
              "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": 165.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 219.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 246.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.33,
              "estimated_amount": 14.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.33,
              "estimated_amount": 14.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 135.45
            },
            {
              "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": 135.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "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": 150.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 225.75
            },
            {
              "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": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "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": 150.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 301
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "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": 246.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 246.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 165.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 219.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "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": 255.85
            },
            {
              "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": 301,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.43,
              "estimated_amount": 24.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.88,
              "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": 255.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "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": 75.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 246.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.43,
              "estimated_amount": 24.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.88,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.88,
              "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": 16.71,
              "estimated_amount": 16.71
            },
            {
              "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": 246.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.33,
              "estimated_amount": 14.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.88,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 165.55
            },
            {
              "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": 301,
              "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": 225.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 165.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 219.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 225.75
            },
            {
              "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": 246.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 219.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.43,
              "estimated_amount": 24.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.12,
              "estimated_amount": 38.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 165.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.33,
              "estimated_amount": 14.33
            },
            {
              "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": 255.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 246.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 255.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 165.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 219.73
            },
            {
              "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": 135.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.66,
              "estimated_amount": 62.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.88,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 150.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 165.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cortisol Total",
      "code_information": [
        {
          "code": "PX-30100199",
          "type": "CDM"
        },
        {
          "code": "82533",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 72,
          "discounted_cash": 46.8,
          "minimum": 13.98,
          "maximum": 61.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 72
            },
            {
              "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": "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": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.46,
              "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": 16.3,
              "estimated_amount": 16.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "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": "HUMANA [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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "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": 61.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "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": 63.36
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.3,
              "estimated_amount": 16.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.12,
              "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": 52.56
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.98,
              "estimated_amount": 13.98
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.3,
              "estimated_amount": 16.3
            },
            {
              "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": 72,
              "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": 59.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 59.04
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.82,
              "estimated_amount": 23.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.98,
              "estimated_amount": 13.98
            },
            {
              "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": "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 [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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.12,
              "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": 72,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.46,
              "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": 61.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.46,
              "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": 61.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.98,
              "estimated_amount": 13.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.3,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 59.04
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.3,
              "estimated_amount": 16.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.3,
              "estimated_amount": 16.3
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.82,
              "estimated_amount": 23.82
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.3,
              "estimated_amount": 16.3
            },
            {
              "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": 59.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.3,
              "estimated_amount": 16.3
            },
            {
              "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 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": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 59.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.98,
              "estimated_amount": 13.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.82,
              "estimated_amount": 23.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.42,
              "estimated_amount": 37.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 61.13,
              "estimated_amount": 61.13
            },
            {
              "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": "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "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": 61.13,
              "estimated_amount": 61.13
            }
          ]
        }
      ]
    },
    {
      "description": "Cyanide Sendout",
      "code_information": [
        {
          "code": "PX-30100213",
          "type": "CDM"
        },
        {
          "code": "82600",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 191,
          "discounted_cash": 124.15,
          "minimum": 16.64,
          "maximum": 72.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 143.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 143.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 139.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 139.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 139.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.64,
              "estimated_amount": 16.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "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": 162.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 156.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 139.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 191,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 162.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 156.62
            },
            {
              "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": 47.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "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": 139.43
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.54,
              "estimated_amount": 22.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "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": 156.62
            },
            {
              "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": 156.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 156.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 191,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 191,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 124.15
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.27,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 156.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 139.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 156.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 162.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "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": 156.62
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 162.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 162.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "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": 105.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.64,
              "estimated_amount": 16.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.27,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "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": 191,
              "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": 191,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.64,
              "estimated_amount": 16.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "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": 168.08
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 191
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 162.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 191,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 143.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.4,
              "estimated_amount": 19.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "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": 191,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 105.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.59,
              "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": 162.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 162.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 162.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.28,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.15,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 19.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 20.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.54,
              "estimated_amount": 22.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.27,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.75,
              "estimated_amount": 72.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 191,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.64,
              "estimated_amount": 16.64
            }
          ]
        }
      ]
    },
    {
      "description": "HC Dihydrotestosterone Dht",
      "code_information": [
        {
          "code": "PX-30100223",
          "type": "CDM"
        },
        {
          "code": "80327",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 140,
          "discounted_cash": 91,
          "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": 89.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 140,
              "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": 119
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 105
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 140,
              "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": 140,
              "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": 123.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.48
            },
            {
              "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": 122.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.88
            },
            {
              "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": 114.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 140
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 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": 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": 77.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 105
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 38.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 140,
              "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": 119
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 113.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 102.2
            },
            {
              "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": 89.88
            },
            {
              "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": 77.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 88.48
            },
            {
              "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": 91.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 119
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 116.06
            },
            {
              "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": 114.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 140,
              "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": 116.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 140,
              "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": 140,
              "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": 89.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.88
            },
            {
              "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": 89.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.8
            },
            {
              "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": 88.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 114.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 119
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "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": 88.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.88
            },
            {
              "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": 140,
              "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": 77.7
            },
            {
              "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": 116.06
            },
            {
              "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": 88.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.48
            },
            {
              "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": 89.88
            },
            {
              "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": 89.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.48
            },
            {
              "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": 122.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 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": 89.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.2
            },
            {
              "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": 102.2
            },
            {
              "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": 77.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.88
            },
            {
              "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": 91.14
            },
            {
              "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": 119
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 113.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 140,
              "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": 140,
              "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": 105
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.2
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "HC Erythropoietin",
      "code_information": [
        {
          "code": "PX-30100229",
          "type": "CDM"
        },
        {
          "code": "82668",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 89,
          "discounted_cash": 57.85,
          "minimum": 16.12,
          "maximum": 70.46,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "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": 48.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "UHC 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,
              "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": 48.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "MOLINA 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.98,
              "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": 50,
              "estimated_amount": 44.5
            },
            {
              "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": 44.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.79,
              "estimated_amount": 18.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.46,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.12,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.79,
              "estimated_amount": 18.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.98,
              "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": 18.79,
              "estimated_amount": 18.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "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": 72.98
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.73,
              "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": 48.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.98,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "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": 72.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.98,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.98,
              "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": 75.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "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": 22.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "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": 75.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "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": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.73,
              "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": 89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.12,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.46,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.12,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.12,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "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": 40.05
            },
            {
              "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": 78.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.46,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.75
            },
            {
              "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": 40.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "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": 72.98
            },
            {
              "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": 64.97
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.79,
              "estimated_amount": 18.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.79,
              "estimated_amount": 18.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "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": 75.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 18.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.73,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.79,
              "estimated_amount": 18.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "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": 57.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.79,
              "estimated_amount": 18.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.46,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.34,
              "estimated_amount": 26.34
            }
          ]
        }
      ]
    },
    {
      "description": "Estradiol; Total",
      "code_information": [
        {
          "code": "PX-30100230",
          "type": "CDM"
        },
        {
          "code": "82670",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 53,
          "discounted_cash": 34.45,
          "minimum": 23.97,
          "maximum": 104.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.94,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "MOLINA 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.83,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.94,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.94,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.94,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.97,
              "estimated_amount": 23.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "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": 43.46
            },
            {
              "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": 45.05
            },
            {
              "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": 34.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "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": 43.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.22,
              "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": 45,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.97,
              "estimated_amount": 23.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.22,
              "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": 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": 45.05
            },
            {
              "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": 23.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.22,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "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": 46.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "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": 43.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "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": 53,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.22,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.83,
              "estimated_amount": 40.83
            },
            {
              "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": 29.15
            },
            {
              "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": 23.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 29.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 53
            },
            {
              "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": 26.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "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": 53,
              "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": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.94,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.94,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27.94,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 23.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40.83,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.69
            },
            {
              "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": 38.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 27.94,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.22,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.07,
              "estimated_amount": 32.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 26.5
            },
            {
              "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": 13.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.97,
              "estimated_amount": 23.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.15
            },
            {
              "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": 23.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.78,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.97,
              "estimated_amount": 23.97
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 1 3/4 in Sur-Fit Invisclose W/ Filter",
      "code_information": [
        {
          "code": "PX-CH-CV4113-60",
          "type": "CDM"
        },
        {
          "code": "A4425",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.11,
          "discounted_cash": 3.97,
          "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": 3.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.46
            },
            {
              "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": 5.36
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.01
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.11,
              "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": 6.11,
              "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": 3.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.11,
              "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": 3.86
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 5.38
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.98
            },
            {
              "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": 6.11,
              "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": 6.11,
              "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": 3.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.01
            },
            {
              "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": 5.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 6.11,
              "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": 6.11,
              "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": 3.39
            },
            {
              "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": 6.11,
              "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": 6.11,
              "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": 5.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 3.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 6.11,
              "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": 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": 3.39
            },
            {
              "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": 6.11,
              "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": 6.11,
              "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": 6.11,
              "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": 5.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.36
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "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": 3.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.46
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.11,
              "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": 3.98
            },
            {
              "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": 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": 5.19
            },
            {
              "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": 3.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 6.11,
              "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": 5.19
            },
            {
              "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": 3.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 4.46
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.46
            },
            {
              "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": 6.11,
              "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": 6.11,
              "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": 3.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.07
            },
            {
              "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": 5.01
            },
            {
              "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": 5.01
            },
            {
              "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": 6.11,
              "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": 5.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 3.36
            },
            {
              "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": 6.11,
              "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": 3.86
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "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": 6.11,
              "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": 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": 4.46
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 5.19
            },
            {
              "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": 3.92
            },
            {
              "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": 3.36
            },
            {
              "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": 4.46
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 3.39
            },
            {
              "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": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 6.11,
              "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": 6.11,
              "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": 6.11,
              "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": 3.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.11,
              "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": 6.11,
              "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": 6.11,
              "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": 3.86
            },
            {
              "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": 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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.67
            },
            {
              "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": 6.11,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 6.37,
          "discounted_cash": 4.14,
          "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": 4.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            },
            {
              "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": 6.37,
              "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": 3.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.15
            },
            {
              "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": 6.37,
              "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": 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": 5.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.09
            },
            {
              "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": 6.37,
              "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": 6.37,
              "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": 5.15
            },
            {
              "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": 4.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            },
            {
              "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": 6.37,
              "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": 5.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.28
            },
            {
              "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": 1.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 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": 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": 5.22
            },
            {
              "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": 6.37,
              "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": 3.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.65
            },
            {
              "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": 4.09
            },
            {
              "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": 5.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 6.37,
              "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": 3.5
            },
            {
              "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": 6.37,
              "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": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 6.37,
              "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": 6.37,
              "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": 4.09
            },
            {
              "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": 5.22
            },
            {
              "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": 4.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 5.22
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "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": 6.37,
              "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": 6.37,
              "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": 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": 3.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 6.37,
              "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": 6.37,
              "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": 4.15
            },
            {
              "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": 4.15
            },
            {
              "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": 6.37,
              "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": 6.37,
              "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": 6.37,
              "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": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "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": 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": 3.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.37,
              "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": 4.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.03
            },
            {
              "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": 6.37,
              "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": 6.37,
              "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": 5.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.5
            },
            {
              "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": 6.37,
              "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": 6.37,
              "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": 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": 5.22
            },
            {
              "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": 6.37,
              "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": 5.28
            },
            {
              "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": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 6.37,
              "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": 5.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.03
            },
            {
              "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": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 5.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.37,
              "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": 6.37,
              "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": 5.22
            },
            {
              "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": 6.37,
              "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": 4.15
            },
            {
              "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": 5.59
            },
            {
              "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": 5.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 4.65
            },
            {
              "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": 6.37,
              "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": 5.41
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 5.39,
          "discounted_cash": 3.5,
          "payers_information": [
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "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": 5.39,
              "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": 5.39,
              "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": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 3.46
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.51
            },
            {
              "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": 4.36
            },
            {
              "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": 3.46
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 3.46
            },
            {
              "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": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 3.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "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": 4.58
            },
            {
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 4.58
            },
            {
              "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": 2.99
            },
            {
              "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": 2.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "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": 2.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "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": 5.39,
              "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": 4.47
            },
            {
              "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": 3.51
            },
            {
              "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": 4.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 4.47
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.39,
              "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": 4.42
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 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": 3.46
            },
            {
              "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": 5.39,
              "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": 3.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.36
            },
            {
              "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": 4.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "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": 1.47
            },
            {
              "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": 5.39,
              "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": 4.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "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": 3.46
            },
            {
              "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": 5.39,
              "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": 4.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "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": 4.42
            },
            {
              "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": 5.39,
              "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": 5.39,
              "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": 4.58
            },
            {
              "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": 3.93
            },
            {
              "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": 5.39,
              "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": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 4.73
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.39
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 3.51
            },
            {
              "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": 5.39,
              "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": 5.39,
              "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": 4.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.39,
              "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": 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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "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": 3.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "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": 2.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 4.47
            },
            {
              "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": 5.39,
              "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": 4.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 4.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.51
            },
            {
              "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": 4.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.04
            },
            {
              "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": 2.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.39,
              "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": 3.46
            },
            {
              "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": 4.42
            },
            {
              "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": 5.39,
              "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": 3.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 3.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "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": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 2.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 2.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "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": 5.39,
              "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": 5.39,
              "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": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "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": 3.46
            },
            {
              "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": 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": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 2.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "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": 3.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 4.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "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": 5.39,
              "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": 4.58
            },
            {
              "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": 2.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 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": 5.39,
              "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": 5.39,
              "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": 3.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.93
            },
            {
              "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": 5.39,
              "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": 2.99
            },
            {
              "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": 3.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 4.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.39,
              "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": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.04
            },
            {
              "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": 5.39,
              "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": 1.47
            },
            {
              "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": 3.93
            },
            {
              "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": 5.39,
              "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": 3.41
            },
            {
              "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": 5.39,
              "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": 4.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.39,
              "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": 3.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.51
            },
            {
              "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": 4.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "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": 4.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.39,
              "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": 2.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.96
            },
            {
              "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": 3.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.42
            },
            {
              "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": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.39,
              "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": 5.39,
              "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": 5.39,
              "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": 4.47
            },
            {
              "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": 5.39,
              "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": 4.74
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ph Blood Gas",
      "code_information": [
        {
          "code": "PX-30100252",
          "type": "CDM"
        },
        {
          "code": "82800",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 95,
          "discounted_cash": 61.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.99
            },
            {
              "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": 83.6
            },
            {
              "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": 52.73
            },
            {
              "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": 52.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "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": 69.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.25
            },
            {
              "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": 60.99
            },
            {
              "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": 80.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 69.35
            },
            {
              "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": 60.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "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": 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": 60.99
            },
            {
              "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": 77.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 71.25
            },
            {
              "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": 60.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 69.35
            },
            {
              "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": 76.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 71.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 69.35
            },
            {
              "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": 52.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "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": 61.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.25
            },
            {
              "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": 95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "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": 25.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "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": 60.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.99
            },
            {
              "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": 60.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.85
            },
            {
              "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": 77.9
            },
            {
              "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": 60.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.04
            },
            {
              "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": 83.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.99
            },
            {
              "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": 61.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 77.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 61.85
            },
            {
              "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": 83.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "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": 60.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 76.86
            },
            {
              "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": 78.76
            },
            {
              "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": 80.75
            },
            {
              "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": 95,
              "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": 80.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 71.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 69.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "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": 52.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "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": 61.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            },
            {
              "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": 60.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 41.25,
              "estimated_amount": 41.25
            }
          ],
          "minimum": 12.04,
          "maximum": 41.25
        }
      ]
    },
    {
      "description": "Deodorizer Pouch Lubricating Adapt 0.27 Oz",
      "code_information": [
        {
          "code": "PX-CH-HO78501",
          "type": "CDM"
        },
        {
          "code": "A4394",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.45,
          "discounted_cash": 0.29,
          "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": 0.29
            },
            {
              "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": 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": 0.37
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.25
            },
            {
              "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": "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": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.45,
              "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": 0.45,
              "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": 0.29
            },
            {
              "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": 0.29
            },
            {
              "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": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "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": "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": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "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": 0.29
            },
            {
              "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": 0.28
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "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": 0.45,
              "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": 0.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": "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": "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": "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": "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": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.33
            },
            {
              "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": 0.25
            },
            {
              "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": 0.45,
              "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": 0.28
            },
            {
              "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": "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": "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": "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": "AETNA [310]",
              "plan_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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "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": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.29
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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/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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "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": 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": 0.28
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.45,
              "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": 0.45,
              "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": 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": 0.29
            },
            {
              "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": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "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 GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "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": 0.29
            },
            {
              "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": "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 FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "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"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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": "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.33
            }
          ]
        }
      ]
    },
    {
      "description": "Hemoglobin Stability Screen Sendout",
      "code_information": [
        {
          "code": "PX-30100284",
          "type": "CDM"
        },
        {
          "code": "83068",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 153,
          "discounted_cash": 99.45,
          "minimum": 6.65,
          "maximum": 35.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 111.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 111.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 153,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 111.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 125.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 153,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.26,
              "estimated_amount": 7.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 125.46
            },
            {
              "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": 111.69
            },
            {
              "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": 153,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "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": 130.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 125.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "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": 130.05
            },
            {
              "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": 125.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 153,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "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": 84.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "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": 153,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "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": 38.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 153,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.94,
              "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": 84.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 111.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 153
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "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": 134.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 111.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 125.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 153,
              "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": 153,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.96,
              "estimated_amount": 9.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.26,
              "estimated_amount": 7.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.26,
              "estimated_amount": 7.26
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "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": 9.47,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "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": 125.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.26,
              "estimated_amount": 7.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 125.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.94,
              "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": 84.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 9.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "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": 130.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.98,
              "estimated_amount": 10.98
            },
            {
              "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": 125.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 130.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.96,
              "estimated_amount": 9.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.65,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.51,
              "estimated_amount": 35.51
            }
          ]
        }
      ]
    },
    {
      "description": "HC 17-Hydroxycorticosteroid",
      "code_information": [
        {
          "code": "PX-30100290",
          "type": "CDM"
        },
        {
          "code": "83491",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 543,
          "discounted_cash": 352.95,
          "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": 348.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "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": 343.18
            },
            {
              "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": 343.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.94,
              "estimated_amount": 24.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 353.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "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": 348.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "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": 461.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 407.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "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": 476.21
            },
            {
              "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": 298.65
            },
            {
              "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": 348.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 353.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "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": 461.55
            },
            {
              "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": 543,
              "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": 461.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "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": 543,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 450.15
            },
            {
              "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": 445.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 450.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 353.49
            },
            {
              "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": 445.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 353.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 439.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 407.25
            },
            {
              "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": 343.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 450.15
            },
            {
              "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": 348.61
            },
            {
              "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": 348.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 407.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "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": 353.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 445.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 301.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 301.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.94,
              "estimated_amount": 24.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 439.29
            },
            {
              "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": 543,
              "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": 461.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 396.39
            },
            {
              "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": 352.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 461.55
            },
            {
              "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": 348.61
            },
            {
              "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": 148.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 301.37
            },
            {
              "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": 301.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 396.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 445.26
            },
            {
              "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": 476.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 343.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 543
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "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": 477.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 348.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 298.65
            }
          ],
          "minimum": 24.94,
          "maximum": 67.13
        }
      ]
    },
    {
      "description": "HC Methsuximide",
      "code_information": [
        {
          "code": "PX-30100333",
          "type": "CDM"
        },
        {
          "code": "80339",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 238,
          "discounted_cash": 154.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 148.75
            },
            {
              "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": 107.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 107.1
            },
            {
              "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": 202.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.74
            },
            {
              "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": 148.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 238,
              "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": 154.7
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 107.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "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": 238,
              "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": 238,
              "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": 202.3
            },
            {
              "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": 173.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 238
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 62.5,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 107.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 107.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 107.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "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": 59.5
            },
            {
              "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": 195.16
            },
            {
              "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": 107.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 238,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 173.74
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 148.75
            },
            {
              "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": 238,
              "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": 238,
              "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": 202.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "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": 148.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.74
            },
            {
              "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": 107.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 148.75
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "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": 148.75
            },
            {
              "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": 195.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 130.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 209.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 238,
              "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": 62.5,
              "estimated_amount": 148.75
            },
            {
              "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": 148.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 107.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "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": 130.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 119
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 238,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 107.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "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": 195.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "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": 178.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.74
            },
            {
              "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": 119
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 238,
              "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": 238,
              "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": 202.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 119
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.16
            }
          ],
          "minimum": 3.51,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "HC Alkaline Phosphatase Alk Phos",
      "code_information": [
        {
          "code": "PX-30100360",
          "type": "CDM"
        },
        {
          "code": "84075",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10,
          "discounted_cash": 6.5,
          "minimum": 4.26,
          "maximum": 19.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "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 MEIJER STEPS2HEALTH [555210]",
              "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": "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": "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 [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 8.2
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.56,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "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": 10,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 8.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "estimated_amount": 4.26
            },
            {
              "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": 4.5
            },
            {
              "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": 4.5
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 8.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 8.2
            },
            {
              "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": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": "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": "HUMANA [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": "MOLINA 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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 25,
              "estimated_amount": 2.5
            },
            {
              "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": "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": "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": "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 POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": 8.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": 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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.56,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "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": 5.18,
              "estimated_amount": 5.18
            },
            {
              "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": 8.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "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": 7.56,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "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": 5.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "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": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "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": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": 8.5
            },
            {
              "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": "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/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.91,
              "estimated_amount": 12.91
            },
            {
              "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": "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": "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": "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.5
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.26,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 5
            }
          ]
        }
      ]
    },
    {
      "description": "Gloves Latex Powder-Free Medium",
      "code_information": [
        {
          "code": "PX-CH-M9PF4002",
          "type": "CDM"
        },
        {
          "code": "A4927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.1,
          "discounted_cash": 0.06,
          "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": 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": "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": "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": "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": "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": "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": "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 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": "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": "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": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.1,
              "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": 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 BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "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": 0.08
            },
            {
              "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": 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": "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 OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "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": 0.1,
              "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": 0.06
            },
            {
              "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": "AETNA [310]",
              "plan_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": "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": "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": "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 OXFORD [625260]",
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": "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": "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": "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": "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": "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": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.09
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.1,
              "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": 0.06
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": "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": 0.1,
              "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": 0.1,
              "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": 0.06
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "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": 0.1,
              "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": 0.1,
              "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": 0.08
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": "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": "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": "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": "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": "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": "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "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": 0.09
            },
            {
              "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": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            }
          ]
        }
      ]
    },
    {
      "description": "Vma Urine Sendout",
      "code_information": [
        {
          "code": "PX-30100450",
          "type": "CDM"
        },
        {
          "code": "84585",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 64,
          "discounted_cash": 41.6,
          "minimum": 11.51,
          "maximum": 58.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.29,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "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": 54.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.5,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.5,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.66,
              "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,
              "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": 52.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.5,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "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": 54.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.29,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.28,
              "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": 54.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "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": 32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.29,
              "estimated_amount": 13.29
            },
            {
              "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": 64,
              "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": 45,
              "estimated_amount": 28.8
            },
            {
              "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": 52.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.5,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.5,
              "estimated_amount": 15.5
            },
            {
              "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": 46.72
            },
            {
              "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": 32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.29,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 45,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.5,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.66,
              "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": 52.48
            },
            {
              "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": 28.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "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": 64,
              "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": 50,
              "estimated_amount": 32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 56.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.5,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "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": 16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "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": 41.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.72
            },
            {
              "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": 52.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "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": 35.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 15.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.51,
              "estimated_amount": 11.51
            },
            {
              "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": 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": 52.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 58.13,
              "estimated_amount": 58.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC Methylenedioxyamphetamines (Mda, Mdea, Mdma) So",
      "code_information": [
        {
          "code": "PX-30101240",
          "type": "CDM"
        },
        {
          "code": "80359",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 85,
          "discounted_cash": 55.25,
          "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": 54.57
            },
            {
              "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": 53.72
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 55.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 72.25
            },
            {
              "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": 47.18
            },
            {
              "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": 74.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 54.57
            },
            {
              "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": 54.57
            },
            {
              "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": 54.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 85,
              "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": 85,
              "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": 47.18
            },
            {
              "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": 69.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "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": 85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 54.57
            },
            {
              "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": 23.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 54.57
            },
            {
              "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": 54.57
            },
            {
              "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": 62.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 63.75
            },
            {
              "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": 53.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 85,
              "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": 55.34
            },
            {
              "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": 53.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "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": 46.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 68.77
            },
            {
              "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": 74.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 55.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 63.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 55.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 72.25
            },
            {
              "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": 72.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 72.25
            },
            {
              "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": 74.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 55.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.75
            },
            {
              "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": 85,
              "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": 72.25
            },
            {
              "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": 54.57
            },
            {
              "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": 55.34
            },
            {
              "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": 69.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 69.7
            },
            {
              "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": 69.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 85,
              "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": 70.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 63.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 85,
              "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": 54.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 70.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 85,
              "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": 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": 47.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "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": 62.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "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": 85,
              "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": 72.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 72.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 70.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 54.57
            },
            {
              "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": 54.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.72
            },
            {
              "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": 47.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 54.57
            },
            {
              "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": 68.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "HC Antidepressants Tricyclic and Other Cyclicals; 6 or More So",
      "code_information": [
        {
          "code": "PX-30101242",
          "type": "CDM"
        },
        {
          "code": "80337",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 184,
          "discounted_cash": 119.6,
          "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": 118.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 138
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 134.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 156.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 138
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 156.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 156.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 102.12
            },
            {
              "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": 152.54
            },
            {
              "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": 118.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 156.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 148.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 161.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.2
            },
            {
              "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": 161.37
            },
            {
              "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": 134.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 184,
              "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": 156.4
            },
            {
              "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": 102.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 134.32
            },
            {
              "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": 118.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 134.32
            },
            {
              "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": 102.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 184,
              "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": 156.4
            },
            {
              "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": 119.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 119.6
            },
            {
              "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": 184,
              "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": 152.54
            },
            {
              "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": 116.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 156.4
            },
            {
              "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": 101.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 156.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.88
            },
            {
              "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": 102.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.2
            },
            {
              "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": 161.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 184,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 119.78
            },
            {
              "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": 150.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 156.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 119.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 156.4
            },
            {
              "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": 184,
              "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": 152.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 119.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 148.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 116.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 184
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.2
            },
            {
              "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": 116.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 134.32
            },
            {
              "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": 118.13
            },
            {
              "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": 50.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 119.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 138
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 134.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 156.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.88
            },
            {
              "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": 118.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 184,
              "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": 156.4
            },
            {
              "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": 118.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.13
            },
            {
              "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": 150.88
            },
            {
              "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": 150.88
            },
            {
              "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": 116.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.13
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "HC St Sensory Integration 15 Min",
      "code_information": [
        {
          "code": "PX-44000039",
          "type": "CDM"
        },
        {
          "code": "97533",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 161,
          "discounted_cash": 104.65,
          "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": 103.36
            },
            {
              "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": 103.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "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": 161,
              "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": 161,
              "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": 43.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 132.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161,
              "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": 103.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 136.85
            },
            {
              "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": 104.65
            },
            {
              "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": 141.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "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": 132.02
            },
            {
              "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": 103.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161,
              "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": 133.47
            },
            {
              "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": 136.85
            },
            {
              "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": 141.2
            },
            {
              "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": 132.02
            },
            {
              "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": 101.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 133.47
            },
            {
              "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": 133.47
            },
            {
              "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": 161,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "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": 117.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "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": 141.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 136.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "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": 89.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 104.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 88.55
            },
            {
              "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": 136.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 104.81
            },
            {
              "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": 101.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161,
              "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": 136.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161,
              "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": 88.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 89.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "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": 103.36
            },
            {
              "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": 101.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161,
              "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": 161,
              "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": 161,
              "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": 136.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 120.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 161
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.55
            },
            {
              "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": 89.36
            },
            {
              "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": 89.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.36
            },
            {
              "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": 104.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 161,
              "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": 132.02
            },
            {
              "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": 104.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 120.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 104.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 130.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.53
            },
            {
              "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": 130.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 136.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 161,
              "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": 120.75
            },
            {
              "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": 103.36
            }
          ]
        }
      ]
    },
    {
      "description": "Stethoscope Disposable Blue",
      "code_information": [
        {
          "code": "PX-CH-A5665Y-10",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.89,
          "discounted_cash": 1.88,
          "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": 1.86
            },
            {
              "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": "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 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "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": "BUCKEYE COMMUNITY 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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "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": 2.89,
              "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": 1.86
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.88
            },
            {
              "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": 1.88
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.89
            },
            {
              "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": 2.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "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": "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": "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": "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": "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 [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": "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": "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": "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": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.4
            },
            {
              "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": "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": "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": "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": "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 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/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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.4
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.11
            },
            {
              "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": 1.86
            },
            {
              "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.34
            },
            {
              "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": "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": "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": "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": "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": "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": "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
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "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": 2.54
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 1.88
            },
            {
              "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": 1.59
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "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": "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 [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "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": 2.34
            },
            {
              "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": "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 OXFORD [625260]",
              "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": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            }
          ]
        }
      ]
    },
    {
      "description": "Filters Charcoal Pack of 10",
      "code_information": [
        {
          "code": "PX-CH-CO0509",
          "type": "CDM"
        },
        {
          "code": "A4368",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.51,
          "discounted_cash": 5.53,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 7.23
            },
            {
              "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": 5.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.54
            },
            {
              "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": 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": 5.54
            },
            {
              "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": "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": "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.51,
              "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": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 6.98
            },
            {
              "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": 5.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 4.68
            },
            {
              "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": 7.49
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "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": 8.51,
              "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": 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": 6.21
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 8.51,
              "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": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "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": 5.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.72
            },
            {
              "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": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 8.51,
              "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": 8.51,
              "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": 5.53
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.51,
              "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": 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": 6.98
            },
            {
              "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": 7.05
            },
            {
              "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 MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.51,
              "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": 5.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 8.51,
              "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": 5.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.38
            },
            {
              "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": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 8.51,
              "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": 7.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 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": 5.54
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 5.46
            },
            {
              "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": 6.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 6.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.38
            },
            {
              "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": 5.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.21
            },
            {
              "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
            },
            {
              "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 6.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 7.23
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "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": 8.51,
              "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": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Tray Driveline Management Lvad Daily",
      "code_information": [
        {
          "code": "PX-CH-TRS-DT18715",
          "type": "CDM"
        },
        {
          "code": "A4550",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23.96,
          "discounted_cash": 15.57,
          "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": 15.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 20.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 15.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 19.38
            },
            {
              "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": 19.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.38
            },
            {
              "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": 19.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 15.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.49
            },
            {
              "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": 23.96,
              "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": 13.18
            },
            {
              "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": 13.18
            },
            {
              "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": 15.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 23.96,
              "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": 20.37
            },
            {
              "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": 15.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.6
            },
            {
              "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": 23.96,
              "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": 23.96,
              "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": 13.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 13.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.65
            },
            {
              "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": 15.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 15.38
            },
            {
              "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": 15.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 20.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 23.96,
              "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": 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": 13.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 23.96,
              "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": 23.96,
              "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": 23.96,
              "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": 21.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.38
            },
            {
              "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": 19.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 20.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.37
            },
            {
              "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": 23.96,
              "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": 20.37
            },
            {
              "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": 23.96,
              "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": 17.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "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": 19.38
            },
            {
              "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": 6.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.38
            },
            {
              "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": 15.38
            },
            {
              "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": 19.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.65
            },
            {
              "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": 17.49
            },
            {
              "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": 15.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.37
            },
            {
              "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": 13.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.37
            },
            {
              "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": 21.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.18
            },
            {
              "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": 21.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.38
            },
            {
              "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": 15.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.49
            },
            {
              "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": 15.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hemoglobin A1c",
      "code_information": [
        {
          "code": "PX-30100703",
          "type": "CDM"
        },
        {
          "code": "83036",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 102,
          "discounted_cash": 66.3,
          "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": 65.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "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": 66.4
            },
            {
              "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": 83.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.48
            },
            {
              "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": 83.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.81,
              "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": 64.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.2,
              "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": 102,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.19,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 76.5
            },
            {
              "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": 86.7
            },
            {
              "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": 89.76
            },
            {
              "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": 65.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "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": 66.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.64
            },
            {
              "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": 56.61
            },
            {
              "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": 56.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 83.64
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.2,
              "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": 56.1
            },
            {
              "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": 84.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.19,
              "estimated_amount": 14.19
            },
            {
              "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": 66.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "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": 74.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.19,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 76.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.2,
              "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": 102,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "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": 56.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.46
            },
            {
              "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": 89.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 102
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.46
            },
            {
              "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": 65.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "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": 64.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "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": 102,
              "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": 86.7
            },
            {
              "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": 89.45
            },
            {
              "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": 64.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.48
            },
            {
              "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": 65.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 82.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 84.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "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": 83.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            },
            {
              "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": 56.1
            },
            {
              "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": 82.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 9.71,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.81,
              "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": 27.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.46
            },
            {
              "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": 64.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.1
            },
            {
              "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": 65.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 84.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.41,
              "estimated_amount": 36.41
            }
          ],
          "minimum": 9.71,
          "maximum": 36.41
        }
      ]
    },
    {
      "description": "2 Pc Ctf Std Wear Up to 1 in Sur-Fit",
      "code_information": [
        {
          "code": "PX-CH-CV1252-64",
          "type": "CDM"
        },
        {
          "code": "A4414",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.29,
          "discounted_cash": 5.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 8.29,
              "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": 5.32
            },
            {
              "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": 5.32
            },
            {
              "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": 2.26
            },
            {
              "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": 8.29,
              "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": 7.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 7.05
            },
            {
              "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": 8.29,
              "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": 5.24
            },
            {
              "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": 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": 6.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 4.56
            },
            {
              "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": 8.29,
              "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": 6.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 6.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 6.8
            },
            {
              "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": 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": 7.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.56
            },
            {
              "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": 8.29,
              "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": 5.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.24
            },
            {
              "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": 5.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.32
            },
            {
              "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": 6.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.22
            },
            {
              "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": 8.29,
              "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": 7.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 7.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.4
            },
            {
              "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": 8.29,
              "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": 8.29,
              "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": 4.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.6
            },
            {
              "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": 5.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 8.29,
              "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": 6.8
            },
            {
              "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": 8.29,
              "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": 63.2,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 8.29,
              "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": 8.29,
              "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": 8.29,
              "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": 4.56
            },
            {
              "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": 4.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 6.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 5.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 8.29,
              "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": 5.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.22
            },
            {
              "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": 8.29,
              "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": 6.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.24
            },
            {
              "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": 8.29,
              "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": 7.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 5.32
            },
            {
              "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": 5.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 8.29,
              "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": 7.27
            },
            {
              "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": 5.4
            },
            {
              "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": 8.29,
              "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": 8.29,
              "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": 6.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.05
            },
            {
              "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": 6.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.29,
              "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": 7.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.24
            },
            {
              "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": 8.29,
              "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": 6.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.05
            },
            {
              "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": 8.29,
              "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": 4.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.29,
              "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": 8.29,
              "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": 8.29,
              "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": 8.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.05
            },
            {
              "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": 8.29,
              "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": 6.71
            },
            {
              "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": 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": 6.87
            }
          ]
        }
      ]
    },
    {
      "description": "Beta 2 Glycoprotein 1 Antibody Each Sendout",
      "code_information": [
        {
          "code": "PX-30200013",
          "type": "CDM"
        },
        {
          "code": "86146",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 71,
          "discounted_cash": 46.15,
          "minimum": 16.45,
          "maximum": 95.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 35.5
            },
            {
              "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": 58.22
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "MOLINA 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.72,
              "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": 50,
              "estimated_amount": 35.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.22
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.72,
              "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": 60.35
            },
            {
              "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": 17.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "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": 62.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.72,
              "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": 71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 35.5
            },
            {
              "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": 58.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "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": 60.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.83,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 31.95
            },
            {
              "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": 31.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "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": 71,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.83,
              "estimated_amount": 34.83
            },
            {
              "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": 31.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "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": 46.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "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": 35.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.83,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.22
            },
            {
              "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": 60.35
            },
            {
              "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": 71,
              "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": 39.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "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": 60.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "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": 31.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 35.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "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": 53.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 35.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 35.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 35.5
            },
            {
              "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": 51.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 35.5
            },
            {
              "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": 58.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.22
            },
            {
              "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": 39.05
            },
            {
              "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": 35.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.83
            }
          ]
        }
      ]
    },
    {
      "description": "Skin Test TB Intradermal Sendout",
      "code_information": [
        {
          "code": "PX-30200067",
          "type": "CDM"
        },
        {
          "code": "86580",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 101,
          "discounted_cash": 65.65,
          "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": 64.84
            },
            {
              "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": 27.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "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": 63.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 27.8,
              "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": 85.85
            },
            {
              "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": 64.84
            },
            {
              "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": 27.24,
              "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": 56.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.33,
              "estimated_amount": 5.33
            },
            {
              "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": 63.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 56.06
            },
            {
              "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": 101,
              "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": 64.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "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": 65.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.73
            },
            {
              "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": 26.25,
              "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": 64.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.33,
              "estimated_amount": 5.33
            },
            {
              "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": 85.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.73
            },
            {
              "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": 26.25,
              "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": 26.25,
              "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": 27.29,
              "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": 64.84
            },
            {
              "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": 64.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.82
            },
            {
              "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": 28.61,
              "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": 63.83
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.33,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "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": 101,
              "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": 73.73
            },
            {
              "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": 27.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "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": 85.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 101
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.55
            },
            {
              "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": 88.58
            },
            {
              "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": 63.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.83
            },
            {
              "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": 73.73
            },
            {
              "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": 27.24,
              "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": 55.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.75
            },
            {
              "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": 65.75
            },
            {
              "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": 55.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 81.71
            },
            {
              "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": 65.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "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": 82.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.82
            },
            {
              "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": 27.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.06
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "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": 88.88
            },
            {
              "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": 85.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 27.8,
              "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": 64.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.73
            },
            {
              "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": 83.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.82
            },
            {
              "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": 56.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 27.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 27.24,
              "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": 64.84
            },
            {
              "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": 82.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26.25,
              "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": 82.82
            },
            {
              "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": 101,
              "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": 63.83
            },
            {
              "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": 26.25,
              "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": 88.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 81.71
            }
          ],
          "minimum": 5.33,
          "maximum": 93.6
        }
      ]
    },
    {
      "description": "HC Campylobacter Jejuni Antibody",
      "code_information": [
        {
          "code": "PX-30200079",
          "type": "CDM"
        },
        {
          "code": "86625",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 78,
          "discounted_cash": 50.7,
          "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": 50.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "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": 49.3
            },
            {
              "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": 50.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 50.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 50.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 64.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 63.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 78,
              "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": 66.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "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": 78,
              "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": 50.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 63.96
            },
            {
              "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": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "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": 63.96
            },
            {
              "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": 21.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "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": 68.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 58.5
            },
            {
              "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": 68.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "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": 68.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "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": 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": 63.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "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": 43.29
            },
            {
              "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": 43.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.67,
              "estimated_amount": 18.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.67,
              "estimated_amount": 18.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 42.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 64.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 64.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.94
            },
            {
              "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": 66.3
            },
            {
              "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": 43.29
            },
            {
              "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": 66.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 43.29
            },
            {
              "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": 78,
              "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": 49.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 66.3
            },
            {
              "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": 50.7
            },
            {
              "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": 63.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "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": 56.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.96
            },
            {
              "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": 49.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.9
            },
            {
              "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": 50.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.2,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.78
            },
            {
              "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": 50.78
            }
          ],
          "minimum": 18.67,
          "maximum": 49.2
        }
      ]
    },
    {
      "description": "Barrier Skin 4 in X 4 in Extended Wear",
      "code_information": [
        {
          "code": "PX-CH-HO8800",
          "type": "CDM"
        },
        {
          "code": "A4385",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.63,
          "discounted_cash": 3.01,
          "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": 2.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.8
            },
            {
              "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": 4.63,
              "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": 4.63,
              "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": 2.55
            },
            {
              "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": 4.63,
              "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": 4.63,
              "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": 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": 2.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.63,
              "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": 3.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.93
            },
            {
              "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": 4.63,
              "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": 2.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.47
            },
            {
              "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": 4.63,
              "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": 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": 3.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.47
            },
            {
              "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": 4.63,
              "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": 2.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.55
            },
            {
              "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": 4.63,
              "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": 3.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.47
            },
            {
              "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": 4.06
            },
            {
              "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": 2.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 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": 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": 3.75
            },
            {
              "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": 1.26
            },
            {
              "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": 4.63,
              "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": 4.63,
              "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": 3.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.63,
              "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": 4.63,
              "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": 2.97
            },
            {
              "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": 4.63,
              "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": 3.94
            },
            {
              "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": 4.63,
              "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": 4.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.93
            },
            {
              "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": 4.63,
              "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": 4.63,
              "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": 4.63,
              "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": 4.63,
              "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": 2.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.84
            },
            {
              "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": 4.63,
              "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": 2.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 3.01
            },
            {
              "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": 3.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.38
            },
            {
              "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": 2.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.63,
              "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": 3.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.63,
              "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": 2.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.55
            },
            {
              "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": 4.63,
              "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": 4.63,
              "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": 3.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.75
            },
            {
              "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": 4.63,
              "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": 2.57
            },
            {
              "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": 4.06
            },
            {
              "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": 4.63,
              "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": 3.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.55
            },
            {
              "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": 3.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.63,
              "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": 4.63,
              "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": 2.97
            },
            {
              "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": 3.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.63,
              "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": 2.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.63,
              "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": 4.63,
              "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": 3.8
            },
            {
              "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": 4.63,
              "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": 3.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.94
            },
            {
              "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": 2.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.63,
              "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": 4.63,
              "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": 4.63,
              "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": 3.01
            },
            {
              "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": 4.63,
              "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": 3.84
            }
          ]
        }
      ]
    },
    {
      "description": "HC Helicobacter Iga Igm So",
      "code_information": [
        {
          "code": "PX-30200099",
          "type": "CDM"
        },
        {
          "code": "86677",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 88,
          "discounted_cash": 57.2,
          "minimum": 12.44,
          "maximum": 63.19,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.2,
              "estimated_amount": 21.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "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": 48.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "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": 64.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.07,
              "estimated_amount": 17.07
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.2,
              "estimated_amount": 21.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "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": 72.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.02,
              "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": 74.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.44,
              "estimated_amount": 12.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.44,
              "estimated_amount": 12.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "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": 22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "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": 72.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "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": 74.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.16
            },
            {
              "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": 72.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.44,
              "estimated_amount": 12.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.44,
              "estimated_amount": 12.44
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "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": 74.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "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": 57.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "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": 88,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.2,
              "estimated_amount": 21.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.83,
              "estimated_amount": 18.83
            },
            {
              "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": 72.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.85,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.85,
              "estimated_amount": 16.85
            },
            {
              "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": 77.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.07,
              "estimated_amount": 17.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.19,
              "estimated_amount": 63.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 74.8
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Tube Site Polymem 3 1/2 in X 3 1/2 In",
      "code_information": [
        {
          "code": "PX-CH-FM5335",
          "type": "CDM"
        },
        {
          "code": "A6209",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.86,
          "discounted_cash": 3.81,
          "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": 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": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 3.25
            },
            {
              "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": 3.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.98
            },
            {
              "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 PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.28
            },
            {
              "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": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 5.86,
              "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": 5.86,
              "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": 3.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.98
            },
            {
              "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": 3.7
            },
            {
              "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": 5.86,
              "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": 5.86,
              "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": 4.98
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 5.86,
              "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": 5.86,
              "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": 3.25
            },
            {
              "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": 5.86,
              "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": 4.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "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": 5.86,
              "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": 4.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.86,
              "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": 4.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "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": 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": 3.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.98
            },
            {
              "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": 5.86,
              "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": 3.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.86
            },
            {
              "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": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 5.16
            },
            {
              "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": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 5.86
            },
            {
              "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 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 CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 5.86,
              "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": 5.86,
              "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": 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": 3.25
            },
            {
              "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": 5.86,
              "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": 5.86,
              "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": 5.86,
              "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": 3.76
            },
            {
              "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": 5.86,
              "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": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 4.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.7
            },
            {
              "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": 5.86,
              "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": 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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.86,
              "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": 4.98
            },
            {
              "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": 4.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 3.22
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "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": 4.28
            },
            {
              "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": 5.86,
              "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": 3.22
            },
            {
              "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": 5.86,
              "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": 5.86,
              "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": 3.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.4
            },
            {
              "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": 5.86,
              "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": 4.81
            },
            {
              "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/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 4.98
            },
            {
              "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": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.86,
              "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": 5.86,
              "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": 4.81
            },
            {
              "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": 5.86,
              "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": 3.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.98
            },
            {
              "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": 4.81
            },
            {
              "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": 5.14
            },
            {
              "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": 5.86,
              "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": 4.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.28
            },
            {
              "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": 4.28
            }
          ]
        }
      ]
    },
    {
      "description": "HC Blepharotomy for Abscess Drainage",
      "code_information": [
        {
          "code": "PX-45000251",
          "type": "CDM"
        },
        {
          "code": "67700",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1894,
          "discounted_cash": 1231.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "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": 1232.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1041.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1041.7
            },
            {
              "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": 1661.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1570.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1041.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1894,
              "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": 1392.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1894,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "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": 1393.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1532.25
            },
            {
              "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": 1553.08
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1382.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1386.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1386.41
            },
            {
              "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": 1570.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1894,
              "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": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1232.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1386.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1609.9
            },
            {
              "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": 1382.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.08
            },
            {
              "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": 1894,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1666.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1382.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1393.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 73.5,
              "estimated_amount": 1392.09
            },
            {
              "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": 1386.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "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": 1553.08
            },
            {
              "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": 1041.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1382.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1386.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1894,
              "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": 1420.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "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": 1231.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1232.99
            },
            {
              "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": 517.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1386.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1382.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1232.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1420.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1041.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1041.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1420.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1393.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1894
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1392.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1570.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "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": 1609.9
            },
            {
              "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": 1232.99
            },
            {
              "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": 1609.9
            },
            {
              "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": 1386.41
            },
            {
              "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": 1894,
              "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": 1894,
              "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": 1894,
              "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": 1894,
              "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": 1894,
              "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": 1041.7
            },
            {
              "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": 1661.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1894,
              "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": 73.5,
              "estimated_amount": 1392.09
            },
            {
              "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": 1393.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1532.25
            },
            {
              "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": 1386.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1894,
              "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": 1609.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1609.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1382.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1553.08
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter External All Silicone Int. 30mm Self Sealing Conveen",
      "code_information": [
        {
          "code": "PX-CH-MN5230H",
          "type": "CDM"
        },
        {
          "code": "A4349",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.02,
          "discounted_cash": 1.31,
          "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": 1.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "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": 2.02,
              "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": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.66
            },
            {
              "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": 1.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.28
            },
            {
              "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": 2.02,
              "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": 2.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 1.28
            },
            {
              "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": 1.32
            },
            {
              "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": 1.67
            },
            {
              "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": 1.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 1.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.28
            },
            {
              "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": 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": 1.3
            },
            {
              "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": 2.02,
              "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": 1.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "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": 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": 1.3
            },
            {
              "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": 1.32
            },
            {
              "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": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 1.72
            },
            {
              "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": 1.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "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": 1.28
            },
            {
              "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": 2.02,
              "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": 2.02,
              "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": 1.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "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": 1.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.11
            },
            {
              "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": 1.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 1.72
            },
            {
              "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": 1.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.32
            },
            {
              "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": 1.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 2.02,
              "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": 1.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "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": 1.3
            },
            {
              "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": 1.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 1.28
            },
            {
              "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": 1.12
            },
            {
              "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": 1.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.12
            },
            {
              "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": 0.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ferritin So",
      "code_information": [
        {
          "code": "PX-30101263",
          "type": "CDM"
        },
        {
          "code": "82728",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 246,
          "discounted_cash": 159.9,
          "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": 157.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 201.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.31,
              "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": 160.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 184.5
            },
            {
              "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": 246,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.91,
              "estimated_amount": 19.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 246
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 160.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 155.47
            },
            {
              "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": 215.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.3
            },
            {
              "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": 246,
              "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": 203.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.77,
              "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": 135.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 201.72
            },
            {
              "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": 155.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 184.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 157.93
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.63,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 157.93
            },
            {
              "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": 160.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.63,
              "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": 135.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 155.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 184.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 157.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 201.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.91,
              "estimated_amount": 19.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.77,
              "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": 199.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 155.47
            },
            {
              "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": 215.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "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": 136.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.63,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 155.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "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": 157.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 157.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.77,
              "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": 201.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "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": 246,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.31,
              "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": 155.47
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.63,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "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": 159.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.63,
              "estimated_amount": 13.63
            },
            {
              "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": 135.3
            },
            {
              "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": 136.53
            },
            {
              "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": 203.93
            },
            {
              "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": 157.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 160.15
            },
            {
              "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": 155.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "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": 216.48
            },
            {
              "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": 157.93
            },
            {
              "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": 157.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 136.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.91,
              "estimated_amount": 19.91
            },
            {
              "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": 209.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.63,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 203.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 160.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 201.72
            },
            {
              "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": 201.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "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": 155.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "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": 199.01
            },
            {
              "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": 201.72
            },
            {
              "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": 67.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "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": 179.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.11,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 157.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 157.93
            },
            {
              "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": 157.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.63,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 209.1
            },
            {
              "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": 201.72
            },
            {
              "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": 209.1
            },
            {
              "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": 136.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 13.63,
          "maximum": 51.11
        }
      ]
    },
    {
      "description": "Wrap Self-Adherent Wrap Coban 6 in X 5 Yds",
      "code_information": [
        {
          "code": "PX-CH-3M1586",
          "type": "CDM"
        },
        {
          "code": "A6455",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.61,
          "discounted_cash": 2.35,
          "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": 2.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 3.61,
              "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": 3.61,
              "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": 2.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.32
            },
            {
              "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": 3.61,
              "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": 3.07
            },
            {
              "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": 3.61,
              "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": 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": 2.32
            },
            {
              "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": 2.96
            },
            {
              "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": 3.07
            },
            {
              "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": 3.61,
              "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": 3.61,
              "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": 2.71
            },
            {
              "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": 2.64
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.32
            },
            {
              "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": 2.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "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": 2.28
            },
            {
              "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": 2.99
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "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": 1.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 3.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.32
            },
            {
              "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": 2.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 3.07
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.61,
              "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": 3.61,
              "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": 0.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 3.61,
              "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": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 3.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 3.61,
              "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": 3.61,
              "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": 2.92
            },
            {
              "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": 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": 2.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.64
            },
            {
              "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": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 2.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.35
            },
            {
              "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": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 3.61,
              "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": 2.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 2.35
            },
            {
              "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": 2.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.96
            },
            {
              "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": 3.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.61,
              "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": 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": 2.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 2.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.61,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Perineal Skin Cleanser Spray 8 Oz W/ Benzalkonium Cardinal",
      "code_information": [
        {
          "code": "PX-CH-IMC55CSCPRSKA8",
          "type": "CDM"
        },
        {
          "code": "A4335",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.43,
          "discounted_cash": 2.23,
          "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": 2.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.89
            },
            {
              "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": 3.43,
              "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": 3.43
            },
            {
              "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": 3.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.23
            },
            {
              "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": 2.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.92
            },
            {
              "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": 3.43,
              "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": 3.43,
              "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": 1.89
            },
            {
              "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": 3.43,
              "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": 2.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.81
            },
            {
              "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": 3.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 1.89
            },
            {
              "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": 3.43,
              "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": 2.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 2.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.9
            },
            {
              "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": 2.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 3.43,
              "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": 2.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 3.43,
              "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": 2.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.89
            },
            {
              "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": 3.43,
              "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": 2.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.84
            },
            {
              "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": 3.43,
              "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": 2.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.2
            },
            {
              "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": 2.77
            },
            {
              "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": 3.43,
              "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": 2.81
            },
            {
              "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": 2.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 2.2
            },
            {
              "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": 2.23
            },
            {
              "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": 3.43,
              "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": 3.43,
              "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": 2.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 2.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.2
            },
            {
              "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": 2.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.92
            },
            {
              "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": 3.43,
              "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": 2.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 3.43,
              "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": 3.43,
              "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": 3.43,
              "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": 3.43,
              "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": 2.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.43,
              "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": 2.17
            },
            {
              "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": 3.43,
              "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": 3.43,
              "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": 2.17
            },
            {
              "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": 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": 2.81
            },
            {
              "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": 3.43,
              "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": 2.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 0.94
            },
            {
              "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": 3.02
            },
            {
              "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": 3.43,
              "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": 2.5
            },
            {
              "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": 3.43,
              "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": 2.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 2.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.92
            },
            {
              "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": 3.43,
              "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": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 2.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.89
            },
            {
              "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": 3.43,
              "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": 2.2
            },
            {
              "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": 2.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.43,
              "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": 1.89
            },
            {
              "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": 1.9
            },
            {
              "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": 2.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.17
            },
            {
              "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": 3.43,
              "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": 2.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.84
            }
          ]
        }
      ]
    },
    {
      "description": "Complement Antigen Each Component Sendout",
      "code_information": [
        {
          "code": "PX-30200355",
          "type": "CDM"
        },
        {
          "code": "86160",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 108,
          "discounted_cash": 70.2,
          "minimum": 10.28,
          "maximum": 45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 88.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "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": 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": 88.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.6,
              "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": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 78.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "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": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 108
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "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": 78.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "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": 27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 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": 88.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 59.4
            },
            {
              "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": 95.04
            },
            {
              "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": 48.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 91.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "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": 88.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "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": 91.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "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": 108,
              "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": 91.8
            },
            {
              "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": 54
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 91.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 88.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 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": 88.56
            },
            {
              "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": 88.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.54,
              "estimated_amount": 17.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 54
            },
            {
              "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": 48.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.54,
              "estimated_amount": 17.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "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": 91.8
            },
            {
              "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": 108,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "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": 50,
              "estimated_amount": 54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 91.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 78.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 48.6
            },
            {
              "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": 48.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 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": 70.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.54,
              "estimated_amount": 17.54
            },
            {
              "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": 108,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Complement Functional Activity Each Sendout",
      "code_information": [
        {
          "code": "PX-30200367",
          "type": "CDM"
        },
        {
          "code": "86161",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 272,
          "discounted_cash": 176.8,
          "minimum": 10.28,
          "maximum": 45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 272,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 176.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.6,
              "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": 50,
              "estimated_amount": 136
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 136
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.54,
              "estimated_amount": 17.54
            },
            {
              "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": 198.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "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": 231.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "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": 231.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 198.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.6,
              "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": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 136
            },
            {
              "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": 136
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 198.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 136
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 136
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 122.4
            },
            {
              "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": 136
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 122.4
            },
            {
              "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": 272,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 136
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 136
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 198.56
            },
            {
              "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": 272,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 122.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 239.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 204
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "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": 223.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 122.4
            },
            {
              "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": 223.04
            },
            {
              "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": 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": 149.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 122.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 122.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 122.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 204
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.12,
              "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": 231.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 136
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.6,
              "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": 272
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 204
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.54,
              "estimated_amount": 17.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.54,
              "estimated_amount": 17.54
            },
            {
              "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": 223.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.28,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 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": 231.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "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": 122.4
            },
            {
              "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": 122.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45,
              "estimated_amount": 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": 223.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "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": 122.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12,
              "estimated_amount": 12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            }
          ]
        }
      ]
    },
    {
      "description": "Blood Pressure Cuff Adult Disposable Latex Free W/O Conn",
      "code_information": [
        {
          "code": "PX-CH-A58400A-10",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.03,
          "discounted_cash": 7.17,
          "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": 7.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 11.03,
              "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": 7.08
            },
            {
              "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": 11.03,
              "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": 7.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 6.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 11.03,
              "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": 11.03,
              "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": 11.03,
              "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": 6.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.38
            },
            {
              "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": 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": 11.03,
              "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": 6.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.38
            },
            {
              "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": 9.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 9.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 8.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 11.03,
              "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": 9.38
            },
            {
              "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": 9.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.07
            },
            {
              "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": 6.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.97
            },
            {
              "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": 9.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.05
            },
            {
              "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": 7.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.97
            },
            {
              "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": 8.05
            },
            {
              "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": 3.01
            },
            {
              "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": 7.08
            },
            {
              "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": 7.18
            },
            {
              "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": 6.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 8.05
            },
            {
              "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": 9.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 7.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 7.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 11.03,
              "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": 8.92
            },
            {
              "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": 6.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.07
            },
            {
              "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": 9.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 8.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "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": 9.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 8.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "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": 6.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 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": 9.71
            },
            {
              "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": 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": 9.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.04
            },
            {
              "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": 7.08
            },
            {
              "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": 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": 9.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.03,
              "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": 6.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.05
            },
            {
              "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": 9.04
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrogen Peroxide 16 Oz",
      "code_information": [
        {
          "code": "PX-CH-MZMDS098001",
          "type": "CDM"
        },
        {
          "code": "A6260",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.64,
          "discounted_cash": 1.07,
          "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": 1.05
            },
            {
              "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": 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": 0.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.2
            },
            {
              "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": 1.64,
              "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": 1.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 1.39
            },
            {
              "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": 1.33
            },
            {
              "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": 1.64,
              "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": 1.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 1.39
            },
            {
              "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": 0.9
            },
            {
              "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": 1.64,
              "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": 0.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 0.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.64,
              "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": 1.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.33
            },
            {
              "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": 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": 0.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.34
            },
            {
              "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": 1.36
            },
            {
              "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": 1.64,
              "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": 1.64,
              "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": 1.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.39
            },
            {
              "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": 1.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.2
            },
            {
              "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": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.9
            },
            {
              "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": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.07
            },
            {
              "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": 1.64,
              "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": 0.9
            },
            {
              "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": 1.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.39
            },
            {
              "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": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 1.39
            },
            {
              "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": 1.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 1.64,
              "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": 1.64,
              "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": 1.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 1.64,
              "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": 0.9
            },
            {
              "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": 1.64,
              "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": 1.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.64,
              "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": 1.23
            },
            {
              "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": 1.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.39
            },
            {
              "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": 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": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.64,
              "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": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.34
            },
            {
              "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": 1.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.07
            },
            {
              "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": 1.04
            },
            {
              "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": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.64,
              "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": 1.64,
              "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": 1.64,
              "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": 1.64,
              "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": 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": 1.2
            },
            {
              "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": 1.64,
              "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": 1.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 1.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.23
            }
          ]
        }
      ]
    },
    {
      "description": "Alginate Ag Silvercel 4 in X 8 In",
      "code_information": [
        {
          "code": "PX-CH-JJ800408",
          "type": "CDM"
        },
        {
          "code": "A6197",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29.4,
          "discounted_cash": 19.11,
          "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": 18.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 29.4,
              "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": 24.37
            },
            {
              "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": 24.11
            },
            {
              "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": 29.4,
              "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": 16.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.87
            },
            {
              "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": 19.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.4,
              "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": 21.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.4,
              "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": 29.4,
              "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": 19.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 21.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.46
            },
            {
              "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": 18.87
            },
            {
              "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": 24.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.11
            },
            {
              "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": 16.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.4,
              "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": 29.4,
              "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": 29.4,
              "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": 29.4,
              "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": 24.99
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "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": 18.58
            },
            {
              "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": 29.4,
              "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": 29.4,
              "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": 18.87
            },
            {
              "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": 29.4,
              "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": 18.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 18.87
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.4,
              "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": 22.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 29.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.05
            },
            {
              "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": 24.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.14
            },
            {
              "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": 25.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "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": 16.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 24.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "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": 19.14
            },
            {
              "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": 24.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 29.4,
              "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": 29.4,
              "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": 29.4,
              "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": 19.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.17
            },
            {
              "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": 29.4,
              "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": 24.37
            },
            {
              "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": 18.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 24.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.78
            },
            {
              "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": 8.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 18.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.58
            },
            {
              "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": 18.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.17
            },
            {
              "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": 29.4,
              "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": 25.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 29.4,
              "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": 29.4,
              "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": 24.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.32
            },
            {
              "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": 18.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.17
            },
            {
              "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": 29.4,
              "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": 16.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 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": 23.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 29.4,
              "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": 21.46
            },
            {
              "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": 29.4,
              "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": 29.4,
              "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": 25.87
            },
            {
              "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": 16.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 22.05
            },
            {
              "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": 18.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.4,
              "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": 29.4,
              "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": 29.4,
              "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": 29.4,
              "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": 29.4,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Entamoeba Histolytica Antgn Feces Sendout",
      "code_information": [
        {
          "code": "PX-30200545",
          "type": "CDM"
        },
        {
          "code": "87337",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 291,
          "discounted_cash": 189.15,
          "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": 186.82
            },
            {
              "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": 183.91
            },
            {
              "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": 161.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.44
            },
            {
              "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": 186.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 291
            },
            {
              "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": "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": "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": "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": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": 291,
              "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": 247.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.08,
              "estimated_amount": 17.08
            },
            {
              "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": 247.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": "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": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": 186.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.08,
              "estimated_amount": 17.08
            },
            {
              "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": 189.15
            },
            {
              "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": 291,
              "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": 255.21
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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": "AETNA [310]",
              "plan_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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": 247.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 235.42
            },
            {
              "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": 238.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "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": 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": "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": "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 STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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 MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 291,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": "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": "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": "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": "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": "AETNA [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": "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "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 OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 44.93,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "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
            }
          ],
          "minimum": 17.08,
          "maximum": 44.93
        }
      ]
    },
    {
      "description": "HC Hepatitis Be Antigen",
      "code_information": [
        {
          "code": "PX-30200549",
          "type": "CDM"
        },
        {
          "code": "87350",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 49,
          "discounted_cash": 31.85,
          "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": 31.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "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": 26.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.46
            },
            {
              "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": 31.46
            },
            {
              "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": 31.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "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": 31.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.9
            },
            {
              "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": 30.97
            },
            {
              "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": 49,
              "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": 31.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.75
            },
            {
              "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": 40.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.95
            },
            {
              "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": 41.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 35.77
            },
            {
              "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": 27.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.83,
              "estimated_amount": 16.83
            },
            {
              "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": 31.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "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": 30.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.46
            },
            {
              "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": 31.9
            },
            {
              "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": 13.38
            },
            {
              "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": 42.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "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": 27.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.11,
              "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": 26.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "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": 39.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "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": 42.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "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": 49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 43.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.11,
              "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": 40.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 11.53,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.65,
              "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": 27.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.83,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "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": 40.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "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": 40.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.53,
              "estimated_amount": 11.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.97
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.83,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.62
            },
            {
              "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": 41.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.77
            },
            {
              "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": 31.46
            },
            {
              "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": 31.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 30.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 43.24,
              "estimated_amount": 43.24
            },
            {
              "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": 31.46
            }
          ],
          "minimum": 11.53,
          "maximum": 43.24
        }
      ]
    },
    {
      "description": "HC Factor 11 Clotting Assay",
      "code_information": [
        {
          "code": "PX-30500028",
          "type": "CDM"
        },
        {
          "code": "85270",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1606,
          "discounted_cash": 1043.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 1014.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.05
            },
            {
              "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": 891.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 883.3
            },
            {
              "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": 1031.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1316.92
            },
            {
              "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": 1045.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "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": 1172.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "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": 1299.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1316.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "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": 438.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1331.37
            },
            {
              "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": 1014.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1045.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 1413.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.66,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1316.92
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.66,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.3
            },
            {
              "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": 1014.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.05
            },
            {
              "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": 1365.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1014.99
            },
            {
              "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": 1408.46
            },
            {
              "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": 1031.05
            },
            {
              "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": 1045.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "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": 1031.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 1031.05
            },
            {
              "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": 891.33
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "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": 1316.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1316.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "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": 1031.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.38
            },
            {
              "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": 891.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1014.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 1043.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 891.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1014.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1014.99
            },
            {
              "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": 1316.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "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": 351.71
            },
            {
              "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": 1316.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1204.5
            },
            {
              "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": 1331.37
            },
            {
              "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": 1408.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1045.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1316.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.08,
              "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": 1031.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.8,
              "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": 1606
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1299.25
            },
            {
              "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": 1365.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1014.99
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.9,
              "estimated_amount": 17.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 17.9,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.8,
              "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": 1045.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1331.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.13,
              "estimated_amount": 67.13
            }
          ],
          "minimum": 6.66,
          "maximum": 67.13
        }
      ]
    },
    {
      "description": "HC Arthropod Exam",
      "code_information": [
        {
          "code": "PX-30600130",
          "type": "CDM"
        },
        {
          "code": "87168",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 183,
          "discounted_cash": 118.95,
          "minimum": 3.67,
          "maximum": 16.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "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": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.01,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.23,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "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": 137.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "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": 133.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "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": 150.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "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": 45.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "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": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.23,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "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": 155.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.01,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "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": 155.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "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": 155.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "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": 183
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "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": 150.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "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": 118.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "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": 150.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "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": 100.65
            },
            {
              "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": 133.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "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": 4.27,
              "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": 155.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.23,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "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": 161.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.48,
              "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": 100.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 183,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "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": 150.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "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": 155.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pinworm Prep Rectum",
      "code_information": [
        {
          "code": "PX-30600132",
          "type": "CDM"
        },
        {
          "code": "87172",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 171,
          "discounted_cash": 111.15,
          "minimum": 3.67,
          "maximum": 16.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "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": 85.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 76.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "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": 42.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "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": 111.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "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": 124.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "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": 140.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "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": 76.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 124.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "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": 140.22
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "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": 124.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 124.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "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": 145.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 76.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.23,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.23,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 76.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 76.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 124.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 145.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "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": 145.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 76.95
            },
            {
              "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": 76.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 124.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 76.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "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": 145.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 128.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 140.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 76.95
            },
            {
              "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": 76.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.27,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 128.25
            },
            {
              "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": 94.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 94.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 171
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.01,
              "estimated_amount": 16.01
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.48,
              "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": 150.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.31,
              "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": 50,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.23,
              "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": 128.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Rna Probe Amplified Chlamydia",
      "code_information": [
        {
          "code": "PX-30600196",
          "type": "CDM"
        },
        {
          "code": "87491",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 91,
          "discounted_cash": 59.15,
          "minimum": 34.53,
          "maximum": 131.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "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": 40.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.95
            },
            {
              "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": 91,
              "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": 77.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 45.5
            },
            {
              "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": 45.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.53,
              "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": 66.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.53,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 45.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 22.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 77.35
            },
            {
              "payer_name": "MOLINA 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,
              "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": 50,
              "estimated_amount": 45.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 91
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 45.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.62
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 45.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 45.5
            },
            {
              "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": 74.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.53,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.43
            },
            {
              "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": 91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.05
            },
            {
              "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": 40.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "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": 80.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "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": 40.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 45.5
            },
            {
              "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": 74.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.53,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 45.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 45.5
            },
            {
              "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": 74.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.43
            },
            {
              "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": 77.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 77.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 50.05
            },
            {
              "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": 59.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "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": 66.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.5,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 77.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            }
          ]
        }
      ]
    },
    {
      "description": "Cmv Amplified Probe Sendout",
      "code_information": [
        {
          "code": "PX-30600199",
          "type": "CDM"
        },
        {
          "code": "87496",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 180,
          "discounted_cash": 117,
          "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": 115.56
            },
            {
              "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": "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": "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 HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "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": 113.76
            },
            {
              "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": 117
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "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": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "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": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 157.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 117.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 153
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 147.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "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": "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 MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "AETNA [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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 135
            },
            {
              "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": "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/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 147.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 180
            },
            {
              "payer_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": "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "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": 149.22
            },
            {
              "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": 115.56
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 153
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": "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": "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": "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": "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": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 131.4
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 149.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 117.18
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 99.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 115.56
            },
            {
              "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": 117.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 158.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 153
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 157.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 115.56
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.28,
              "estimated_amount": 51.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 115.56
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            }
          ],
          "minimum": 35.09,
          "maximum": 131.59
        }
      ]
    },
    {
      "description": "Chromosome Analysis Tissue Sendout",
      "code_information": [
        {
          "code": "PX-31000009",
          "type": "CDM"
        },
        {
          "code": "88233",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3422,
          "discounted_cash": 2224.3,
          "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": 2196.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "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": 3422,
              "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": 749.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2196.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 142.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 140.73,
              "estimated_amount": 140.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2227.72
            },
            {
              "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": 2227.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "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": 3011.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "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": 1899.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2836.84
            },
            {
              "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": 2806.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 142.14,
              "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": 2566.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 142.14,
              "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": 2196.92
            },
            {
              "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": 2227.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2498.06
            },
            {
              "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": 2806.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2806.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1899.21
            },
            {
              "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": 2908.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1882.1
            },
            {
              "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": 2224.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1882.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2768.4
            },
            {
              "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": 934.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1882.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3422,
              "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": 2227.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2806.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2806.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 205.64,
              "estimated_amount": 205.64
            },
            {
              "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": 1882.1
            },
            {
              "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": 3001.09
            },
            {
              "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": 2196.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2162.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "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": 1899.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2498.06
            },
            {
              "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": 2836.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2162.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "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": 3422,
              "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": 2566.5
            },
            {
              "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": 2908.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 140.73,
              "estimated_amount": 140.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1882.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 147.77,
              "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": 2162.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 140.73,
              "estimated_amount": 140.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2196.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2806.04
            },
            {
              "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": 2498.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 140.73,
              "estimated_amount": 140.73
            },
            {
              "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": 2196.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2196.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 147.77,
              "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": 2908.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2498.06
            },
            {
              "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": 3001.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "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": 2196.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1882.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3422
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2498.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2162.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1882.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 147.77,
              "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": 2162.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 140.73,
              "estimated_amount": 140.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2196.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 140.73,
              "estimated_amount": 140.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2227.72
            },
            {
              "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": 2162.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2498.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2196.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2566.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 140.73,
              "estimated_amount": 140.73
            },
            {
              "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": 1899.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2836.84
            },
            {
              "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": 2162.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2908.7
            },
            {
              "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": 2196.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 142.14,
              "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": 2162.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 140.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 142.14,
              "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": 2196.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 205.64,
              "estimated_amount": 205.64
            },
            {
              "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": 2806.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 527.74,
              "estimated_amount": 527.74
            },
            {
              "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": 2768.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2806.04
            }
          ],
          "minimum": 140.73,
          "maximum": 527.74
        }
      ]
    },
    {
      "description": "HC Chrom Analysis Add Hi Res Study So",
      "code_information": [
        {
          "code": "PX-31000034",
          "type": "CDM"
        },
        {
          "code": "88289",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 558,
          "discounted_cash": 362.7,
          "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": 358.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 451.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 457.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 418.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 407.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.15,
              "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": 558,
              "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": 352.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "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": 462.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 418.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 418.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 457.56
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.3,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.43,
              "estimated_amount": 34.43
            },
            {
              "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": 457.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 407.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 306.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.43,
              "estimated_amount": 34.43
            },
            {
              "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": 363.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 363.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 457.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 352.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.43,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 558
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "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": 352.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 306.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.77,
              "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": 457.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 457.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 462.58
            },
            {
              "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": 474.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.3,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "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": 358.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "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": 306.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "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": 358.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 306.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 407.34
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.43,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.77,
              "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": 363.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 363.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 457.56
            },
            {
              "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": 362.7
            },
            {
              "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": 457.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.43,
              "estimated_amount": 34.43
            },
            {
              "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": 407.34
            },
            {
              "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": 558,
              "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": 352.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 352.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.77,
              "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": 309.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 306.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.77,
              "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": 309.69
            },
            {
              "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": 152.33
            },
            {
              "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": 358.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "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": 558,
              "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": 462.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 352.66
            },
            {
              "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": 489.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.43,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "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": 309.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 407.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 34.77,
              "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": 474.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "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": 309.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.24
            },
            {
              "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": 358.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.3,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.24
            },
            {
              "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": 363.26
            },
            {
              "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": 489.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 407.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 352.66
            },
            {
              "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": 352.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.43,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 306.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.15,
              "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": 358.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 358.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 129.11,
              "estimated_amount": 129.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 474.3
            },
            {
              "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": 491.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 306.9
            },
            {
              "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": 451.42
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 34.43,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 34.43,
          "maximum": 129.11
        }
      ]
    },
    {
      "description": "HC Gross and Micro Level V 1 Spec",
      "code_information": [
        {
          "code": "PX-31000056",
          "type": "CDM"
        },
        {
          "code": "88307",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 885,
          "discounted_cash": 575.25,
          "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": 64.2,
              "estimated_amount": 568.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 320.12,
              "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": 885,
              "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": 733.67
            },
            {
              "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": 329.41,
              "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": 663.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 646.05
            },
            {
              "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": 313.72,
              "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": 715.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "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": 776.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 320.12,
              "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": 486.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 559.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 725.7
            },
            {
              "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": 575.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 568.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 313.72,
              "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": 568.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 568.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 568.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 568.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 733.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.75
            },
            {
              "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": 646.05
            },
            {
              "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": 559.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 316.86,
              "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": 752.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 576.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 733.67
            },
            {
              "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": 576.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.75
            },
            {
              "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": 313.72,
              "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": 559.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 885
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.75
            },
            {
              "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": 313.72,
              "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": 646.05
            },
            {
              "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": 568.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 663.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 715.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 725.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "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": 778.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.75
            },
            {
              "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": 885,
              "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": 646.05
            },
            {
              "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": 725.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 646.05
            },
            {
              "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": 316.86,
              "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": 241.61
            },
            {
              "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": 486.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "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": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 576.14
            },
            {
              "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": 316.86,
              "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": 329.41,
              "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": 885,
              "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": 752.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "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": 329.41,
              "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": 559.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 752.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 559.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 568.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 568.17
            },
            {
              "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": 316.86,
              "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": 559.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "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": 576.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 725.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 725.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 725.7
            },
            {
              "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": 568.17
            },
            {
              "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": 725.7
            },
            {
              "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": 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": 316.86,
              "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": 752.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 752.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 646.05
            },
            {
              "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": 491.18
            },
            {
              "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": 491.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 576.14
            },
            {
              "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": 559.32
            },
            {
              "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": 776.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 491.18
            },
            {
              "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": 568.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 559.32
            },
            {
              "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": 725.7
            },
            {
              "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": 320.12,
              "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": 568.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 663.75
            }
          ],
          "minimum": 72.1,
          "maximum": 1215.41
        }
      ]
    },
    {
      "description": "HC Electron Microscopy Diagnostic So",
      "code_information": [
        {
          "code": "PX-31000101",
          "type": "CDM"
        },
        {
          "code": "88348",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1734,
          "discounted_cash": 1127.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1113.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1128.83
            },
            {
              "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": 1421.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1265.82
            },
            {
              "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": 379.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1265.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1300.5
            },
            {
              "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": 1437.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1113.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 765.81,
              "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": 1421.88
            },
            {
              "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": 1128.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1421.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1095.89
            },
            {
              "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": 1095.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "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": 1473.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "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": 788.02,
              "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": 750.49,
              "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": 1437.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 953.7
            },
            {
              "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": 758,
              "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": 953.7
            },
            {
              "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": 1734,
              "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": 1128.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "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": 765.81,
              "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": 1473.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1128.83
            },
            {
              "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": 1421.88
            },
            {
              "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": 1421.88
            },
            {
              "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": 1520.72
            },
            {
              "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": 1095.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 1734,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.89,
              "estimated_amount": 185.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 953.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1128.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1734
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 953.7
            },
            {
              "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": 962.37
            },
            {
              "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": 1520.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1113.23
            },
            {
              "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": 1113.23
            },
            {
              "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": 473.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1300.5
            },
            {
              "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": 1113.23
            },
            {
              "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": 1113.23
            },
            {
              "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": 750.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1421.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 962.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 953.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1265.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1421.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 953.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1265.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1095.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1113.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1402.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1300.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1113.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1421.88
            },
            {
              "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": 750.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 1734,
              "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": 1095.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1095.89
            },
            {
              "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": 1265.82
            },
            {
              "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": 758,
              "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": 758,
              "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": 1473.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1437.49
            },
            {
              "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": 1113.23
            },
            {
              "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": 1113.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "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": 788.02,
              "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": 1265.82
            },
            {
              "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": 758,
              "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": 765.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 1525.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1113.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.89,
              "estimated_amount": 185.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 962.37
            },
            {
              "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": 758,
              "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": 788.02,
              "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": 962.37
            },
            {
              "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": 1095.89
            },
            {
              "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": 1127.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1095.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 953.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1473.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1113.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 750.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2911.91,
              "estimated_amount": 2911.91
            },
            {
              "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": 1402.81
            },
            {
              "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": 1473.9
            }
          ],
          "minimum": 185.89,
          "maximum": 2911.91
        }
      ]
    },
    {
      "description": "HC Morph Anlys Ish Manual 1st Probe Stain",
      "code_information": [
        {
          "code": "PX-31000109",
          "type": "CDM"
        },
        {
          "code": "88368",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1100,
          "discounted_cash": 715,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "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": 307.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 716.1
            },
            {
              "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": 706.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "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": 610.5
            },
            {
              "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": 964.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 706.2
            },
            {
              "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": 605
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 911.9
            },
            {
              "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": 935
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 313.36,
              "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": 803
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 316.86,
              "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": 706.2
            },
            {
              "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": 695.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 803
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1100
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 964.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 716.1
            },
            {
              "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": 803
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "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": 313.36,
              "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": 695.2
            },
            {
              "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": 715
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 706.2
            },
            {
              "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": 902
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.09,
              "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": 605
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 610.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "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": 240.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 313.36,
              "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": 706.2
            },
            {
              "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": 706.2
            },
            {
              "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": 889.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 1100,
              "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": 968
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 825
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 610.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 911.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 716.1
            },
            {
              "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": 716.1
            },
            {
              "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": 902
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 316.86,
              "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": 307.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 1100,
              "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": 716.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 889.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 322.45,
              "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": 803
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 316.86,
              "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": 935
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 329.41,
              "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": 935
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 706.2
            },
            {
              "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": 300.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.25,
              "estimated_amount": 144.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 144.25,
              "estimated_amount": 144.25
            },
            {
              "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": 610.5
            },
            {
              "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": 911.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 695.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 329.41,
              "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": 316.86,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 605
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 825
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 316.86,
              "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": 605
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 902
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 935
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1215.41,
              "estimated_amount": 1215.41
            },
            {
              "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": 1100,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 144.25,
          "maximum": 1215.41
        }
      ]
    },
    {
      "description": "HC Xr Ac Joints Bilateral",
      "code_information": [
        {
          "code": "PX-32000066",
          "type": "CDM"
        },
        {
          "code": "73050",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 329,
          "discounted_cash": 213.85,
          "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": 211.22
            },
            {
              "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": 269.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 279.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 214.18
            },
            {
              "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": 329,
              "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": 214.18
            },
            {
              "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": 89.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 180.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.17
            },
            {
              "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": 79.31,
              "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": 214.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 329,
              "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": 266.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 329,
              "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": 180.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 279.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 182.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 269.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 207.93
            },
            {
              "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": 182.6
            },
            {
              "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": 182.6
            },
            {
              "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": 83.28,
              "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": 211.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 246.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 279.65
            },
            {
              "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": 288.53
            },
            {
              "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": 272.74
            },
            {
              "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": 80.93,
              "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": 180.95
            },
            {
              "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": 211.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 266.16
            },
            {
              "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": 269.78
            },
            {
              "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": 83.28,
              "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": 272.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 329
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 269.78
            },
            {
              "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": 207.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 279.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 180.95
            },
            {
              "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": 211.22
            },
            {
              "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": 214.18
            },
            {
              "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": 279.65
            },
            {
              "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": 80.93,
              "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": 240.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 329,
              "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": 279.65
            },
            {
              "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": 207.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 329,
              "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": 246.75
            },
            {
              "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": 180.95
            },
            {
              "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": 288.53
            },
            {
              "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": 80.93,
              "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": 279.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 269.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 180.95
            },
            {
              "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": 80.1,
              "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": 246.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 269.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 289.52
            },
            {
              "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": 80.1,
              "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": 329,
              "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": 329,
              "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": 279.65
            },
            {
              "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": 329,
              "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": 279.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 213.85
            },
            {
              "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": 214.18
            },
            {
              "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": 80.1,
              "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": 83.28,
              "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": 269.78
            },
            {
              "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": 182.6
            },
            {
              "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": 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": 63.2,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 80.1,
              "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": 279.65
            },
            {
              "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": 207.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 279.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 272.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 180.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 79.31,
              "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": 269.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 279.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 80.1,
              "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": 329,
              "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": 329,
              "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": 279.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 329,
              "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": 329,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 329,
              "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": 79.31,
              "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": 279.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Arthrogram Elbow",
      "code_information": [
        {
          "code": "PX-32000070",
          "type": "CDM"
        },
        {
          "code": "73085",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 881,
          "discounted_cash": 572.65,
          "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": 565.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 573.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 881,
              "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": 748.85
            },
            {
              "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": 572.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 484.55
            },
            {
              "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": 643.13
            },
            {
              "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": 748.85
            },
            {
              "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": 772.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 643.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 573.53
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 748.85
            },
            {
              "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": 722.42
            },
            {
              "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": 488.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 488.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 556.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 556.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 730.35
            },
            {
              "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": 722.42
            },
            {
              "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": 556.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 881,
              "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": 748.85
            },
            {
              "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": 565.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 722.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 748.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 775.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 484.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 484.55
            },
            {
              "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": 488.96
            },
            {
              "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": 573.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 730.35
            },
            {
              "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": 712.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 556.79
            },
            {
              "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": 556.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 722.42
            },
            {
              "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": 881,
              "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": 565.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 484.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 643.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 573.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 565.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 748.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 748.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 748.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 556.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 881,
              "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": 722.42
            },
            {
              "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": 488.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 565.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 712.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 643.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 565.6
            },
            {
              "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": 881,
              "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": 660.75
            },
            {
              "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": 565.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 565.6
            },
            {
              "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": 565.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 643.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 722.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 748.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 484.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 643.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 484.55
            },
            {
              "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": 730.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 660.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 748.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 565.6
            },
            {
              "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": 240.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 660.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 556.79
            },
            {
              "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": 772.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 573.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 722.42
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 748.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 881,
              "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": 722.42
            },
            {
              "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": 484.55
            },
            {
              "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": 881,
              "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": 565.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 565.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 748.85
            },
            {
              "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": 556.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 881,
              "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": 881
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Knee 3 Vw",
      "code_information": [
        {
          "code": "PX-32000087",
          "type": "CDM"
        },
        {
          "code": "73562",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 375,
          "discounted_cash": 243.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 240.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 318.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "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": 318.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 237
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.93,
              "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": 240.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 307.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 240.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 303.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 307.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "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": 79.31,
              "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": 237
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 273.75
            },
            {
              "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": 208.13
            },
            {
              "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": 375,
              "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": 375,
              "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": 273.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 375,
              "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": 273.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 281.25
            },
            {
              "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": 307.5
            },
            {
              "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": 330
            },
            {
              "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": 375,
              "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": 375,
              "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": 83.28,
              "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": 244.13
            },
            {
              "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": 80.1,
              "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": 375,
              "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": 375,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 206.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 318.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 375
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.1,
              "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": 318.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 240.75
            },
            {
              "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": 328.88
            },
            {
              "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": 375,
              "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": 237
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 206.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 206.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 206.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 206.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 273.75
            },
            {
              "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": 328.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 208.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 375,
              "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": 375,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 307.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 240.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 240.75
            },
            {
              "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": 307.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 310.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 281.25
            },
            {
              "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": 237
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.93,
              "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": 318.75
            },
            {
              "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": 102.38
            },
            {
              "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": 79.31,
              "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": 240.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 375,
              "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": 375,
              "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": 80.93,
              "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": 240.75
            },
            {
              "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": 79.31,
              "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": 80.1,
              "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": 237
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 240.75
            },
            {
              "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": 303.38
            },
            {
              "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": 307.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 237
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 318.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 244.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 240.75
            },
            {
              "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": 244.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 244.13
            },
            {
              "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": 80.1,
              "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": 80.1,
              "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": 83.28,
              "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": 206.25
            },
            {
              "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": 79.31,
              "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": 208.13
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.28,
              "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": 281.25
            },
            {
              "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": 237
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 206.25
            },
            {
              "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": 240.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 244.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 310.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 307.5
            },
            {
              "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": 208.13
            },
            {
              "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": 310.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 273.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 273.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 240.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 237
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 243.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 375,
              "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": 375,
              "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": 375,
              "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": 307.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Ankle Complete 3 + Vw",
      "code_information": [
        {
          "code": "PX-32000094",
          "type": "CDM"
        },
        {
          "code": "73610",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 369,
          "discounted_cash": 239.85,
          "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": 236.9
            },
            {
              "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": 80.1,
              "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": 233.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 305.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 302.58
            },
            {
              "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": 313.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 269.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.9
            },
            {
              "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": 369,
              "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": 233.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.95
            },
            {
              "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": 202.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 233.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.9
            },
            {
              "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": 298.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 302.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 313.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 313.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.95
            },
            {
              "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": 269.37
            },
            {
              "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": 302.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 302.58
            },
            {
              "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": 233.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 313.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 204.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 369,
              "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": 369,
              "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": 324.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 313.65
            },
            {
              "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": 80.93,
              "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": 202.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.9
            },
            {
              "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": 79.31,
              "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": 80.1,
              "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": 83.28,
              "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": 276.75
            },
            {
              "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": 236.9
            },
            {
              "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": 240.22
            },
            {
              "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": 236.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 276.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 233.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 80.93,
              "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": 369,
              "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": 313.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 313.65
            },
            {
              "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": 369,
              "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": 369,
              "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": 313.65
            },
            {
              "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": 204.8
            },
            {
              "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": 369,
              "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": 302.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 369
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 233.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 313.65
            },
            {
              "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": 80.1,
              "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": 80.1,
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.28,
              "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": 369,
              "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": 276.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 302.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 269.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 240.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 240.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 369,
              "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": 313.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.9
            },
            {
              "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": 240.22
            },
            {
              "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": 323.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 369,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 239.85
            },
            {
              "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": 80.1,
              "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": 302.58
            },
            {
              "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": 302.58
            },
            {
              "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": 233.21
            },
            {
              "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": 305.9
            },
            {
              "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": 236.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 369,
              "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": 233.21
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 313.65
            },
            {
              "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": 236.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 313.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.95
            },
            {
              "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": 323.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 298.52
            },
            {
              "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": 204.8
            },
            {
              "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": 204.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 313.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 269.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 269.37
            },
            {
              "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": 313.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 240.22
            },
            {
              "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": 83.28,
              "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": 100.74
            },
            {
              "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": 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": 305.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 369,
              "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": 369,
              "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": 269.37
            },
            {
              "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": 79.31,
              "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": 80.93,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Foot 2 Vw",
      "code_information": [
        {
          "code": "PX-32000096",
          "type": "CDM"
        },
        {
          "code": "73620",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 282,
          "discounted_cash": 183.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 181.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 205.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 178.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 80.93,
              "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": 231.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 155.1
            },
            {
              "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": 282,
              "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": 181.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 282
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 181.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 211.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 80.93,
              "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": 155.1
            },
            {
              "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": 83.28,
              "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": 239.7
            },
            {
              "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": 83.28,
              "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": 156.51
            },
            {
              "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": 282,
              "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": 181.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 178.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 211.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 239.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 181.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 181.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.93,
              "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": 282,
              "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": 205.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 239.7
            },
            {
              "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": 156.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 155.1
            },
            {
              "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": 178.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 239.7
            },
            {
              "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": 231.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 183.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 205.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 178.22
            },
            {
              "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": 181.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 228.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 231.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 231.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 80.1,
              "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": 178.22
            },
            {
              "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": 282,
              "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": 239.7
            },
            {
              "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": 248.16
            },
            {
              "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": 205.86
            },
            {
              "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": 156.51
            },
            {
              "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": 181.04
            },
            {
              "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": 228.14
            },
            {
              "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": 231.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 239.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 205.86
            },
            {
              "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": 231.24
            },
            {
              "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": 76.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 239.7
            },
            {
              "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": 183.3
            },
            {
              "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": 181.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 181.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 231.24
            },
            {
              "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": 183.58
            },
            {
              "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": 155.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 155.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 282,
              "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": 155.1
            },
            {
              "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": 80.1,
              "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": 155.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 205.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 183.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 79.31,
              "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": 282,
              "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": 178.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 239.7
            },
            {
              "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": 181.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 231.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 239.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 233.78
            },
            {
              "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": 233.78
            },
            {
              "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": 247.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 181.04
            },
            {
              "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": 83.28,
              "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": 282,
              "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": 80.1,
              "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": 178.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 233.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.1,
              "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": 239.7
            },
            {
              "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": 178.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 211.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 183.58
            },
            {
              "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": 79.31,
              "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": 247.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 183.58
            },
            {
              "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": 282,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.1,
              "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": 239.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 156.51
            },
            {
              "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": 239.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 239.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 282,
              "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": 239.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 282,
              "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": 282,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cystogram 3 + Vw",
      "code_information": [
        {
          "code": "PX-32000135",
          "type": "CDM"
        },
        {
          "code": "74430",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 632,
          "discounted_cash": 410.8,
          "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": 405.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 523.93
            },
            {
              "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": 350.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 474
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 411.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 518.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 347.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 461.36
            },
            {
              "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": 518.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 632,
              "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": 556.16
            },
            {
              "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": 405.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 632,
              "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": 350.76
            },
            {
              "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": 399.42
            },
            {
              "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": 461.36
            },
            {
              "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": 350.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 632,
              "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": 411.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 537.2
            },
            {
              "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": 335.65,
              "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": 537.2
            },
            {
              "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": 511.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 518.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 405.74
            },
            {
              "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": 554.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 537.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 399.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 347.6
            },
            {
              "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": 339.01,
              "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": 405.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 474
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 339.01,
              "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": 399.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 537.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 461.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 411.43
            },
            {
              "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": 518.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 518.24
            },
            {
              "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": 335.65,
              "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": 632,
              "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": 537.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 350.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 405.74
            },
            {
              "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": 411.43
            },
            {
              "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": 518.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 399.42
            },
            {
              "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": 399.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 632,
              "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": 537.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 632,
              "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": 347.6
            },
            {
              "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": 352.43,
              "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": 339.01,
              "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": 405.74
            },
            {
              "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": 405.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 411.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 518.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 399.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 399.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 632,
              "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": 632,
              "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": 523.93
            },
            {
              "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": 632,
              "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": 347.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 461.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 537.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 632,
              "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": 632,
              "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": 410.8
            },
            {
              "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": 352.43,
              "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": 632,
              "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": 632,
              "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": 342.5,
              "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": 537.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 461.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 461.36
            },
            {
              "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": 537.2
            },
            {
              "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": 554.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 537.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 518.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 632
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 335.65,
              "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": 632,
              "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": 405.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 511.29
            },
            {
              "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": 172.54
            },
            {
              "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": 352.43,
              "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": 339.01,
              "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": 537.2
            },
            {
              "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": 342.5,
              "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": 339.01,
              "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": 523.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 537.2
            },
            {
              "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": 399.42
            },
            {
              "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": 632,
              "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": 342.5,
              "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": 537.2
            },
            {
              "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": 335.65,
              "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": 632,
              "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": 347.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 347.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 537.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 474
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 347.6
            }
          ]
        }
      ]
    },
    {
      "description": "HC Venocavagram Inferior",
      "code_information": [
        {
          "code": "PX-32000153",
          "type": "CDM"
        },
        {
          "code": "75825",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4458,
          "discounted_cash": 2897.7,
          "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": 2862.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3606.52
            },
            {
              "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": 2781.99,
              "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": 3254.34
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 4458
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2862.04
            },
            {
              "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": 4458,
              "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": 3343.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3923.04
            },
            {
              "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": 2809.81,
              "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": 2902.16
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2897.7
            },
            {
              "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": 4458,
              "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": 3789.3
            },
            {
              "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": 3909.67
            },
            {
              "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": 3909.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "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": 2921.09,
              "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": 3254.34
            },
            {
              "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": 2809.81,
              "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": 2838.77,
              "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": 2862.04
            },
            {
              "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": 1217.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 3789.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 976.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2474.19
            },
            {
              "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": 2862.04
            },
            {
              "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": 2474.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2474.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3695.68
            },
            {
              "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": 2451.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3343.5
            },
            {
              "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": 4458,
              "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": 4458,
              "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": 3789.3
            },
            {
              "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": 2781.99,
              "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": 3254.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 2862.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2921.09,
              "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": 2921.09,
              "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": 2817.46
            },
            {
              "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": 2838.77,
              "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": 4458,
              "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": 2817.46
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3254.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 3789.3
            },
            {
              "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": 2838.77,
              "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": 4458,
              "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": 4458,
              "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": 2862.04
            },
            {
              "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": 3606.52
            },
            {
              "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": 2781.99,
              "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": 3695.68
            },
            {
              "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": 4458,
              "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": 3789.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3695.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2862.04
            },
            {
              "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": 2902.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4458,
              "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": 2451.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2809.81,
              "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": 2781.99,
              "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": 2902.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3655.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2474.19
            },
            {
              "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": 2809.81,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Venogram Adrenal Unilatateral",
      "code_information": [
        {
          "code": "PX-32000157",
          "type": "CDM"
        },
        {
          "code": "75840",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4458,
          "discounted_cash": 2897.7,
          "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": 2862.04
            },
            {
              "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": 2902.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "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": 2902.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3606.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2474.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 4458,
              "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": 2862.04
            },
            {
              "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": 3655.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 4458,
              "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": 3343.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2862.04
            },
            {
              "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": 3655.56
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3254.34
            },
            {
              "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": 3789.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3695.68
            },
            {
              "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": 2451.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 2862.04
            },
            {
              "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": 2474.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3254.34
            },
            {
              "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": 3695.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 2862.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2862.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2902.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3655.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3343.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 3923.04
            },
            {
              "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": 1217.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4458,
              "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": 2451.9
            },
            {
              "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": 4458,
              "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": 2817.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4458
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "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": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 4458,
              "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": 2862.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 2474.19
            },
            {
              "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": 2862.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3254.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3254.34
            },
            {
              "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": 2897.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "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": 3909.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3695.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2817.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 4458,
              "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": 3789.3
            },
            {
              "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": 3254.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4458,
              "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": 3343.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "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": 2474.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 3909.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3789.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2451.9
            },
            {
              "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": 2862.04
            },
            {
              "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": 3606.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3655.56
            }
          ]
        }
      ]
    },
    {
      "description": "HC Endovasc Rep Descending Thoracic Aorta Subclavian",
      "code_information": [
        {
          "code": "PX-32000177",
          "type": "CDM"
        },
        {
          "code": "75956",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1469,
          "discounted_cash": 954.85,
          "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": 943.1
            },
            {
              "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": 1248.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "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": 1292.72
            },
            {
              "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": 928.41
            },
            {
              "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": 1288.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "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": 943.1
            },
            {
              "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": 815.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1469
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1101.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1217.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "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": 943.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1217.8
            },
            {
              "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": 1188.42
            },
            {
              "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": 956.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 1469,
              "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": 1469,
              "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": 956.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 956.32
            },
            {
              "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": 815.3
            },
            {
              "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": 1469,
              "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": 1469,
              "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": 943.1
            },
            {
              "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": 1204.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1469,
              "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": 1101.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 1188.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 943.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1248.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "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": 943.1
            },
            {
              "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": 1204.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "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": 1072.37
            },
            {
              "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": 928.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1072.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 956.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1072.37
            },
            {
              "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": 928.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "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": 401.04
            },
            {
              "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": 1469,
              "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": 1248.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 1072.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1101.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "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": 954.85
            },
            {
              "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": 1217.8
            },
            {
              "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": 807.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "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": 1204.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 815.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1072.37
            },
            {
              "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": 815.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1072.37
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1469,
              "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": 1288.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 943.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1248.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1469,
              "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": 1248.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 956.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            }
          ]
        }
      ]
    },
    {
      "description": "HC Distal Exten Prosth Descending Thoracic Aorta",
      "code_information": [
        {
          "code": "PX-32000180",
          "type": "CDM"
        },
        {
          "code": "75959",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1469,
          "discounted_cash": 954.85,
          "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": 943.1
            },
            {
              "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": 1188.42
            },
            {
              "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": 1469,
              "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": 1248.65
            },
            {
              "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": 943.1
            },
            {
              "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": 815.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 815.3
            },
            {
              "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": 943.1
            },
            {
              "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": 1469,
              "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": 1204.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "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": 956.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "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": 1248.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 1248.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 956.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 943.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1188.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 956.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1072.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1217.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1072.37
            },
            {
              "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": 1469,
              "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": 943.1
            },
            {
              "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": 807.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1072.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1469
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 956.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "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": 815.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1469,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "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": 943.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 1204.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "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": 1288.31
            },
            {
              "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": 943.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1217.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 954.85
            },
            {
              "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": 1204.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "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": 1204.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "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": 1292.72
            },
            {
              "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": 815.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 956.32
            },
            {
              "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": 1204.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "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": 1469,
              "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": 1101.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1101.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 943.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1469,
              "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": 928.41
            },
            {
              "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": 928.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 928.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 928.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 807.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1204.58
            },
            {
              "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": 1248.65
            },
            {
              "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": 1288.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 1072.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 943.1
            },
            {
              "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": 401.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1072.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1248.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1101.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1072.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 928.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1469,
              "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": 943.1
            },
            {
              "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": 1217.8
            }
          ]
        }
      ]
    },
    {
      "description": "HC Transcatheter Biopsy R S&I",
      "code_information": [
        {
          "code": "PX-32000186",
          "type": "CDM"
        },
        {
          "code": "75970",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2506,
          "discounted_cash": 1628.9,
          "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": 1608.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2130.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1583.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "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": 2506,
              "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": 1631.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1631.41
            },
            {
              "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": 2506,
              "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": 1608.85
            },
            {
              "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": 2506,
              "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": 1829.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1583.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2054.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1879.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1583.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "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": 2506,
              "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": 1378.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1378.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1378.3
            },
            {
              "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": 2506,
              "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": 1390.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1378.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2506,
              "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": 2506,
              "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": 2130.1
            },
            {
              "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": 2506,
              "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": 1583.79
            },
            {
              "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": 2506,
              "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": 684.14
            },
            {
              "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": 1583.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2130.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1608.85
            },
            {
              "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": 2054.92
            },
            {
              "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": 1390.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2130.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1829.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "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": 2506,
              "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": 2506,
              "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": 2130.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2054.92
            },
            {
              "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": 1583.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "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": 2077.47
            },
            {
              "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": 2506,
              "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": 1390.83
            },
            {
              "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": 2506,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 548.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2506,
              "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": 1829.38
            },
            {
              "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": 2506,
              "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": 2130.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2130.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1608.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1631.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2027.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2054.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2130.1
            },
            {
              "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": 2506,
              "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": 1608.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1829.38
            },
            {
              "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": 2506,
              "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": 2506,
              "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": 2506,
              "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": 1390.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1583.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1608.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1608.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2054.92
            },
            {
              "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": 2130.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1879.5
            },
            {
              "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": 1829.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2077.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2506
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2077.47
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2506,
              "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": 2506,
              "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": 2506,
              "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": 2130.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1608.85
            },
            {
              "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": 2197.76
            },
            {
              "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": 2506,
              "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": 2130.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1583.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "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": 2205.28
            },
            {
              "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": 2506,
              "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": 2506,
              "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": 1879.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2130.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "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": 1631.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2054.92
            },
            {
              "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": 1378.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2130.1
            },
            {
              "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": 1628.9
            },
            {
              "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": 1608.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1631.41
            },
            {
              "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": 2054.92
            },
            {
              "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": 1608.85
            },
            {
              "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": 2027.35
            },
            {
              "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": 2506,
              "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": 2197.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1378.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1829.38
            },
            {
              "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": 2054.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "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": 2506,
              "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": 2506,
              "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": 2506,
              "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": 1378.3
            },
            {
              "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": 1608.85
            },
            {
              "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": 1608.85
            },
            {
              "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": 2130.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2506,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Unlisted Fluoro Procedure",
      "code_information": [
        {
          "code": "PX-32000199",
          "type": "CDM"
        },
        {
          "code": "76496",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 358,
          "discounted_cash": 232.7,
          "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": 229.84
            },
            {
              "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": 79.31,
              "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": 304.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.3
            },
            {
              "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": 304.3
            },
            {
              "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": 83.28,
              "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": 358,
              "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": 261.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.34
            },
            {
              "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": 226.26
            },
            {
              "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": 229.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.56
            },
            {
              "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": 83.28,
              "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": 358,
              "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": 261.34
            },
            {
              "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": 358,
              "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": 289.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 196.9
            },
            {
              "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": 83.28,
              "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": 304.3
            },
            {
              "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": 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": 296.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.26
            },
            {
              "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": 229.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 233.06
            },
            {
              "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": 313.97
            },
            {
              "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": 80.93,
              "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": 226.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 198.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 358
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 358,
              "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": 79.31,
              "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": 358,
              "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": 304.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 233.06
            },
            {
              "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": 289.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.9
            },
            {
              "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": 358,
              "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": 229.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 80.1,
              "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": 80.1,
              "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": 226.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 80.93,
              "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": 196.9
            },
            {
              "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": 229.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.84
            },
            {
              "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": 293.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.9
            },
            {
              "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": 198.69
            },
            {
              "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": 296.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 196.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.26
            },
            {
              "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": 358,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 196.9
            },
            {
              "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": 80.1,
              "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": 80.1,
              "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": 198.69
            },
            {
              "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": 293.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 233.06
            },
            {
              "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": 97.73
            },
            {
              "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": 79.31,
              "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": 261.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 293.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 304.3
            },
            {
              "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": 304.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.84
            },
            {
              "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": 80.1,
              "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": 304.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 233.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 358,
              "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": 80.93,
              "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": 313.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.56
            },
            {
              "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": 198.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.34
            },
            {
              "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": 226.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 229.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 268.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 358,
              "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": 293.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.3
            },
            {
              "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": 232.7
            },
            {
              "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": 315.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 296.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 268.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.34
            },
            {
              "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": 358,
              "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": 304.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 268.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 358,
              "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": 358,
              "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": 233.06
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mammary Ductogram or Galactogram Mult",
      "code_information": [
        {
          "code": "PX-32000207",
          "type": "CDM"
        },
        {
          "code": "77054",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 517,
          "discounted_cash": 336.05,
          "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": 331.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "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": 423.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 336.57
            },
            {
              "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": 423.94
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "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": 286.94
            },
            {
              "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": 286.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 387.75
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 439.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 439.45
            },
            {
              "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": 517,
              "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": 418.25
            },
            {
              "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": 423.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 387.75
            },
            {
              "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": 517,
              "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": 336.57
            },
            {
              "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": 326.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 439.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 428.59
            },
            {
              "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": 439.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 377.41
            },
            {
              "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": 439.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 517
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 336.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "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": 453.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 286.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "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": 428.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 517,
              "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": 336.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 517,
              "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": 286.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 428.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "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": 453.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 423.94
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 517,
              "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": 439.45
            },
            {
              "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": 517,
              "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": 377.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 387.75
            },
            {
              "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": 377.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 454.96
            },
            {
              "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": 336.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 439.45
            },
            {
              "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": 326.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "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": 517,
              "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": 284.35
            },
            {
              "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": 326.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 418.25
            },
            {
              "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": 284.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 517,
              "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": 517,
              "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": 517,
              "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": 517,
              "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": 336.57
            },
            {
              "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": 141.14
            }
          ]
        }
      ]
    },
    {
      "description": "HC Therapeutic Radiation Simulation Simple",
      "code_information": [
        {
          "code": "PX-33300001",
          "type": "CDM"
        },
        {
          "code": "77280",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1614,
          "discounted_cash": 1049.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1036.19
            },
            {
              "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": 1323.48
            },
            {
              "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": 124.35,
              "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": 1614,
              "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": 895.77
            },
            {
              "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": 1338.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1020.05
            },
            {
              "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": 120.84,
              "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": 1371.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1614
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1210.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 887.7
            },
            {
              "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": 1614,
              "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": 1036.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1036.19
            },
            {
              "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": 118.42,
              "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": 124.35,
              "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": 895.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1338.01
            },
            {
              "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": 120.84,
              "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": 1036.19
            },
            {
              "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": 120.84,
              "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": 1305.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1371.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1614,
              "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": 1036.19
            },
            {
              "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": 1371.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1323.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1020.05
            },
            {
              "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": 1415.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1338.01
            },
            {
              "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": 887.7
            },
            {
              "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": 1050.71
            },
            {
              "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": 119.61,
              "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": 1178.22
            },
            {
              "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": 119.61,
              "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": 1036.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 887.7
            },
            {
              "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": 1323.48
            },
            {
              "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": 1036.19
            },
            {
              "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": 119.61,
              "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": 1614,
              "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": 1614,
              "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": 1415.48
            },
            {
              "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": 1020.05
            },
            {
              "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": 1036.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 887.7
            },
            {
              "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": 124.35,
              "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": 895.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1020.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1020.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1020.05
            },
            {
              "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": 1036.19
            },
            {
              "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": 1050.71
            },
            {
              "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": 118.42,
              "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": 1371.9
            },
            {
              "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": 1049.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 887.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 887.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1614,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 353.47
            },
            {
              "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": 1371.9
            },
            {
              "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": 440.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1614,
              "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": 1371.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1323.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1420.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1050.71
            },
            {
              "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": 119.61,
              "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": 1305.73
            },
            {
              "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": 1323.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1371.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1036.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1050.71
            },
            {
              "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": 1020.05
            },
            {
              "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": 1614,
              "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": 1614,
              "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": 1371.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1614,
              "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": 1323.48
            },
            {
              "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": 1178.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1371.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1371.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1323.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1210.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1210.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1020.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 1614,
              "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": 119.61,
              "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": 1371.9
            },
            {
              "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": 1036.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1614,
              "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": 118.42,
              "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": 1036.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1050.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1323.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1178.22
            },
            {
              "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": 118.42,
              "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": 1178.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 887.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1178.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1178.22
            },
            {
              "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": 1614,
              "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": 895.77
            }
          ]
        }
      ]
    },
    {
      "description": "Lotion Moisturizing Therapy Cream Lantiseptic 4 Oz",
      "code_information": [
        {
          "code": "PX-CH-S40410",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.87,
          "discounted_cash": 5.12,
          "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": 5.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.69
            },
            {
              "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": 6.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.37
            },
            {
              "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": 4.37
            },
            {
              "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": 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": 6.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 5.05
            },
            {
              "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": 5.05
            },
            {
              "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": 5.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 5.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 4.97
            },
            {
              "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": 7.87,
              "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": 6.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.69
            },
            {
              "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": 7.87,
              "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": 5.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.9
            },
            {
              "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": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 6.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.05
            },
            {
              "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": 5.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.12
            },
            {
              "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": 4.33
            },
            {
              "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": 7.87,
              "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": 4.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.33
            },
            {
              "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": 7.87,
              "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": 7.87,
              "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": 6.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "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": 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": 6.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.45
            },
            {
              "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": 4.97
            },
            {
              "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": 7.87,
              "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": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 6.69
            },
            {
              "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": 4.37
            },
            {
              "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": 6.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.69
            },
            {
              "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": 7.87,
              "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": 6.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 7.87,
              "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": 7.87,
              "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": 6.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 5.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "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": 6.69
            },
            {
              "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": 4.97
            },
            {
              "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": 7.87,
              "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": 6.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 6.45
            },
            {
              "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": 2.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 6.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 6.69
            },
            {
              "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": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 7.87,
              "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": 7.87,
              "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": 5.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.87,
              "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": 7.87,
              "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": 5.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.05
            },
            {
              "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": 5.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 7.87,
              "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": 6.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.9
            },
            {
              "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": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.87,
              "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": 7.87,
              "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": 6.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Intestine Imaging Meckels Gastric Mucosa",
      "code_information": [
        {
          "code": "PX-34100025",
          "type": "CDM"
        },
        {
          "code": "78290",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3686,
          "discounted_cash": 2395.9,
          "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": 2366.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3133.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2690.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 3686,
              "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": 3686,
              "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": 2366.41
            },
            {
              "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": 3133.1
            },
            {
              "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": 3133.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2027.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2329.55
            },
            {
              "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": 3232.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 3022.52
            },
            {
              "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": 3243.68
            },
            {
              "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": 2981.97
            },
            {
              "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": 2329.55
            },
            {
              "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": 3686,
              "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": 3686,
              "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": 3133.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3133.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3686,
              "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": 2399.59
            },
            {
              "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": 3022.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 3686,
              "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": 2690.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2366.41
            },
            {
              "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": 2399.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 2045.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3133.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 3133.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2399.59
            },
            {
              "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": 1006.28
            },
            {
              "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": 2045.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2027.3
            },
            {
              "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": 2366.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2399.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3022.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2027.3
            },
            {
              "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": 2690.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 2690.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3133.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3022.52
            },
            {
              "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": 3686,
              "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": 3022.52
            },
            {
              "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": 2027.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 2366.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3022.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2045.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2027.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2366.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3022.52
            },
            {
              "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": 2395.9
            },
            {
              "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": 2366.41
            },
            {
              "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": 2366.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3055.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3686,
              "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": 2690.78
            },
            {
              "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": 2399.59
            },
            {
              "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": 2329.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3686
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3055.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2764.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2981.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2329.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3133.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3133.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2027.3
            },
            {
              "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": 3686,
              "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": 2764.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2027.3
            },
            {
              "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": 3232.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 2366.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3055.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 2366.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2366.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3022.52
            },
            {
              "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": 2045.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2329.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3133.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2690.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2764.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2329.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 3686,
              "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": 2366.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2329.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "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": 3133.1
            },
            {
              "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": 2329.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3686,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cardiac Blood Pool 1st Pass 1 Study Rest or Stress Wm Ef",
      "code_information": [
        {
          "code": "PX-34100043",
          "type": "CDM"
        },
        {
          "code": "78481",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1257,
          "discounted_cash": 817.05,
          "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": 806.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1030.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 942.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 1042.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1257,
              "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": 1257,
              "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": 1068.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 691.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 917.61
            },
            {
              "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": 697.64
            },
            {
              "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": 806.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 806.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1030.74
            },
            {
              "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": 1257,
              "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": 1106.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 691.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 1257,
              "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": 818.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 818.31
            },
            {
              "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": 1042.05
            },
            {
              "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": 917.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 917.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 806.99
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 794.42
            },
            {
              "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": 1030.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 806.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 818.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 806.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 697.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 794.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 794.42
            },
            {
              "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": 1102.39
            },
            {
              "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": 794.42
            },
            {
              "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": 1257,
              "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": 806.99
            },
            {
              "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": 806.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 691.35
            },
            {
              "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": 1257,
              "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": 1257,
              "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": 806.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1030.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1030.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 691.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "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": 697.64
            },
            {
              "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": 818.31
            },
            {
              "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": 1030.74
            },
            {
              "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": 343.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 942.75
            },
            {
              "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": 818.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 691.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 1257,
              "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": 1257,
              "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": 1068.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 1042.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 806.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 1257
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 691.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 794.42
            },
            {
              "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": 794.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 1016.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 794.42
            },
            {
              "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": 817.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 917.61
            },
            {
              "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": 691.35
            },
            {
              "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": 1257,
              "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": 1030.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "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": 1068.45
            },
            {
              "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": 1016.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "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": 697.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 917.61
            },
            {
              "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": 794.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 806.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 942.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1068.45
            },
            {
              "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": 1257,
              "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": 1102.39
            },
            {
              "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": 806.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1030.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 917.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1257,
              "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": 1257,
              "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": 1068.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cardiac Blood Pool Gated Spect Rest Wm Ef",
      "code_information": [
        {
          "code": "PX-34100044",
          "type": "CDM"
        },
        {
          "code": "78494",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2293,
          "discounted_cash": 1490.45,
          "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": 1472.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 2293
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "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": 2010.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 1949.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "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": 2293,
              "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": 2293,
              "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": 2293,
              "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": 1673.89
            },
            {
              "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": 1949.05
            },
            {
              "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": 1949.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "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": 1449.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2293,
              "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": 1900.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "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": 1472.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 1490.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2293,
              "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": 1949.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 1719.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1719.75
            },
            {
              "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": 1492.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1272.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "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": 1472.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "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": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 1472.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1492.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 2293,
              "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": 1272.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "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": 1272.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 1949.05
            },
            {
              "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": 1449.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 2293,
              "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": 1261.15
            },
            {
              "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": 2293,
              "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": 1472.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1900.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 1472.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1492.74
            },
            {
              "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": 1492.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1855.04
            },
            {
              "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": 2017.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 2293,
              "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": 1900.9
            },
            {
              "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": 1472.11
            },
            {
              "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": 2010.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1673.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2293,
              "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": 1880.26
            },
            {
              "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": 1880.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1719.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "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": 2293,
              "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": 1449.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "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": 1272.62
            },
            {
              "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": 1855.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1492.74
            },
            {
              "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": 1880.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1472.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1261.15
            },
            {
              "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": 1673.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1949.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1880.26
            },
            {
              "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": 1261.15
            },
            {
              "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": 625.99
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2293,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pulm Ventilation and Perfusion Imaging",
      "code_information": [
        {
          "code": "PX-34100048",
          "type": "CDM"
        },
        {
          "code": "78582",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1678,
          "discounted_cash": 1090.7,
          "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": 1077.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1357.5
            },
            {
              "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": 471.75,
              "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": 1426.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 922.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1426.3
            },
            {
              "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": 931.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1426.3
            },
            {
              "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": 1375.96
            },
            {
              "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": 1471.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 1426.3
            },
            {
              "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": 1092.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1375.96
            },
            {
              "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": 1060.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 1678
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 481.37,
              "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": 1391.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1426.3
            },
            {
              "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": 1678,
              "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": 922.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1077.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1060.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1060.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 1258.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1426.3
            },
            {
              "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": 471.75,
              "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": 1077.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1375.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1258.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1224.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1060.5
            },
            {
              "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": 1060.5
            },
            {
              "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": 1092.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1092.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 922.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1060.5
            },
            {
              "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": 1471.61
            },
            {
              "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": 481.37,
              "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": 1678,
              "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": 1678,
              "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": 476.46,
              "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": 476.46,
              "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": 1077.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1077.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 922.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1375.96
            },
            {
              "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": 495.33,
              "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": 481.37,
              "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": 1375.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1077.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1375.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1678,
              "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": 1476.64
            },
            {
              "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": 471.75,
              "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": 1678,
              "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": 1678,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 367.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 922.9
            },
            {
              "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": 1426.3
            },
            {
              "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": 931.29
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 495.33,
              "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": 1077.28
            },
            {
              "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": 1357.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1060.5
            },
            {
              "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": 1678,
              "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": 1077.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1224.94
            },
            {
              "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": 1678,
              "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": 1678,
              "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": 1426.3
            },
            {
              "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": 1426.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1092.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1224.94
            },
            {
              "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": 1678,
              "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": 1678,
              "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": 1426.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1426.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1258.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 1678,
              "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": 1077.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 476.46,
              "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": 1391.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 931.29
            },
            {
              "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": 1375.96
            },
            {
              "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": 458.09
            },
            {
              "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": 495.33,
              "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": 1678,
              "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": 1426.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 1077.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1077.28
            },
            {
              "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": 471.75,
              "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": 1077.28
            },
            {
              "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": 1060.5
            },
            {
              "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": 476.46,
              "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": 1426.3
            },
            {
              "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": 1224.94
            },
            {
              "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": 476.46,
              "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": 1391.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 922.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 1426.3
            },
            {
              "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": 931.29
            },
            {
              "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": 922.9
            },
            {
              "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": 1090.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1678,
              "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": 1224.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1224.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1375.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1092.38
            }
          ]
        }
      ]
    },
    {
      "description": "Drainage Bag 4000ml Bedside 4000cc Center Entry Lf",
      "code_information": [
        {
          "code": "PX-CH-BU153509",
          "type": "CDM"
        },
        {
          "code": "A4357",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.58,
          "discounted_cash": 6.88,
          "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": 6.79
            },
            {
              "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": 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": 7.72
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.58,
              "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": 10.58,
              "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": 5.87
            },
            {
              "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": 8.56
            },
            {
              "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": 8.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 5.82
            },
            {
              "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": 9.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 10.58,
              "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": 10.58,
              "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": 10.58,
              "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": 10.58,
              "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": 6.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 5.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 8.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "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": 6.79
            },
            {
              "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": 8.68
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 10.58,
              "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": 5.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 8.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.99
            },
            {
              "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": 10.58,
              "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": 6.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.99
            },
            {
              "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": 10.58,
              "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": 7.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 10.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 10.58,
              "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": 5.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "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": 10.58,
              "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": 10.58,
              "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": 8.99
            },
            {
              "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": 8.68
            },
            {
              "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": 10.58,
              "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": 8.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.82
            },
            {
              "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": 6.69
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.58,
              "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": 7.94
            },
            {
              "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": 10.58,
              "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": 6.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.99
            },
            {
              "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": 9.28
            },
            {
              "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": 10.58,
              "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": 10.58,
              "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": 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": 8.68
            },
            {
              "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": 6.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 10.58,
              "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": 8.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 10.58,
              "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": 9.31
            },
            {
              "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": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.58,
              "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": 8.99
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.69
            },
            {
              "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": 10.58,
              "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": 10.58,
              "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": 10.58,
              "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": 8.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.68
            },
            {
              "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": 10.58,
              "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": 10.58,
              "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": 10.58,
              "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": 6.69
            },
            {
              "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": 5.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "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": 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": 6.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.99
            }
          ]
        }
      ]
    },
    {
      "description": "Reposition Right or Left Vad Percutaneous W/ Img",
      "code_information": [
        {
          "code": "PX-36000056",
          "type": "CDM"
        },
        {
          "code": "33993",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 836,
          "discounted_cash": 543.4,
          "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": 536.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 528.35
            },
            {
              "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": 543.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 836,
              "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": 536.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 685.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.71
            },
            {
              "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": 693.04
            },
            {
              "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": 528.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 693.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.8
            },
            {
              "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": 536.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 528.35
            },
            {
              "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": 676.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 610.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 610.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 685.52
            },
            {
              "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": 733.17
            },
            {
              "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": 528.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 528.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.8
            },
            {
              "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": 836,
              "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": 676.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 685.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 836
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 685.52
            },
            {
              "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": 228.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 610.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 836
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 544.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 685.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 836
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 836,
              "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": 544.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.8
            },
            {
              "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": 733.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 836
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 685.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 544.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 627
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 627
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 610.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 627
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "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": 685.52
            },
            {
              "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": 685.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.8
            },
            {
              "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": 836,
              "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": 536.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.71
            },
            {
              "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": 536.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 544.24
            },
            {
              "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": 836,
              "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": 528.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 610.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 610.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.71
            },
            {
              "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": 710.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            },
            {
              "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": 836,
              "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": 536.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 544.24
            },
            {
              "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": 710.6
            },
            {
              "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": 735.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 528.35
            },
            {
              "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": 459.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 693.04
            },
            {
              "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": 528.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 836
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 710.6
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Lubricath 16 Fr 30cc Coude",
      "code_information": [
        {
          "code": "PX-CH-BA0100L16",
          "type": "CDM"
        },
        {
          "code": "A4340",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39.32,
          "discounted_cash": 25.56,
          "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": 25.24
            },
            {
              "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": 39.32,
              "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": 21.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.63
            },
            {
              "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": 25.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 32.24
            },
            {
              "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": 34.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 21.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 33.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.7
            },
            {
              "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": 39.32,
              "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": 33.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.49
            },
            {
              "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": 39.32,
              "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": 29.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.42
            },
            {
              "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": 25.24
            },
            {
              "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": 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": 39.32,
              "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": 32.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.63
            },
            {
              "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": 39.32,
              "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": 24.85
            },
            {
              "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": 34.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.81
            },
            {
              "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": 21.82
            },
            {
              "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": 39.32,
              "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": 25.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.24
            },
            {
              "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": 34.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 33.42
            },
            {
              "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": 33.42
            },
            {
              "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": 39.32,
              "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": 33.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 33.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.6
            },
            {
              "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": 24.85
            },
            {
              "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": 24.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 39.32,
              "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": 39.32,
              "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": 25.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.42
            },
            {
              "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": 39.32,
              "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": 39.32,
              "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": 39.32,
              "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": 21.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 39.32,
              "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": 39.32,
              "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": 39.32,
              "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": 39.32,
              "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": 25.24
            },
            {
              "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": 25.24
            },
            {
              "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": 32.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 39.32
            },
            {
              "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": 39.32,
              "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": 21.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.24
            },
            {
              "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": 21.82
            },
            {
              "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": 39.32,
              "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": 39.32,
              "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": 25.24
            },
            {
              "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": 31.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 39.32,
              "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": 28.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 25.24
            },
            {
              "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": 28.7
            },
            {
              "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": 39.32,
              "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": 25.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.49
            },
            {
              "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": 32.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.32,
              "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": 39.32,
              "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": 32.24
            },
            {
              "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": 10.73
            },
            {
              "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": 39.32,
              "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": 39.32,
              "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": 25.24
            },
            {
              "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": 39.32,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Induced Del After Partial Miscarriage",
      "code_information": [
        {
          "code": "PX-36000001",
          "type": "CDM"
        },
        {
          "code": "59855",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7622,
          "discounted_cash": 4954.3,
          "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": 4893.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4192.1
            },
            {
              "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": 4893.32
            },
            {
              "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": 4961.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6250.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5716.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4893.32
            },
            {
              "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": 2080.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4817.1
            },
            {
              "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": 4817.1
            },
            {
              "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": 4893.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4817.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5045.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 7622
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 423.08,
              "additional_payer_notes": "PHYSICIAN 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": 7622,
              "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": 6250.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 418.89,
              "estimated_amount": 418.89
            },
            {
              "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": 6684.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 418.89,
              "estimated_amount": 418.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 418.89,
              "estimated_amount": 418.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4961.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 418.89,
              "estimated_amount": 418.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6250.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5716.5
            },
            {
              "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": 4817.1
            },
            {
              "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": 4954.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6250.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4893.32
            },
            {
              "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": 1669.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4817.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 423.08,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 423.08,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 7622
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 7622
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6250.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5564.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 423.08,
              "additional_payer_notes": "PHYSICIAN 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": 4893.32
            },
            {
              "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": 4893.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6166.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6318.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4817.1
            },
            {
              "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": 6707.36
            },
            {
              "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": 6166.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 439.83,
              "additional_payer_notes": "PHYSICIAN 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": 4893.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4961.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4192.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "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": 4192.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 423.08,
              "additional_payer_notes": "PHYSICIAN 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": 6478.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 7622
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5716.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 418.89,
              "estimated_amount": 418.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5564.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5045.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4192.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "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": 7622,
              "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": 6478.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6250.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "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": 7622,
              "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": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "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": 4893.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4893.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5564.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5564.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "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": 6250.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 439.83,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4192.1
            },
            {
              "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": 6478.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6318.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7622,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5045.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4893.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 418.89,
              "estimated_amount": 418.89
            },
            {
              "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": 4893.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4817.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 418.89,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 439.83,
              "additional_payer_notes": "PHYSICIAN 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": 5564.06
            },
            {
              "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": 7622,
              "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": 4961.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5564.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 418.89,
              "estimated_amount": 418.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4870.46
            },
            {
              "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": 6318.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 7622
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4192.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4961.92
            },
            {
              "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": 4817.1
            },
            {
              "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": 6250.04
            },
            {
              "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": 6684.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6478.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 5045.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4192.1
            }
          ],
          "minimum": 418.89,
          "maximum": 418.89
        }
      ]
    },
    {
      "description": "HC Assemble Operate Heartlung Machine",
      "code_information": [
        {
          "code": "PX-36000012",
          "type": "CDM"
        },
        {
          "code": "36000012",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22694,
          "discounted_cash": 14751.1,
          "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": 14569.55
            },
            {
              "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": 14569.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14569.55
            },
            {
              "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": 14751.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14773.79
            },
            {
              "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": 14569.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22694,
              "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": 14569.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14569.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14773.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18609.08
            },
            {
              "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": 19902.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17020.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12481.7
            },
            {
              "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": 14342.61
            },
            {
              "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": 19289.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16566.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18609.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14342.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 22694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18813.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18813.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18359.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12481.7
            },
            {
              "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": 22694,
              "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": 19289.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14342.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14342.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12481.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16566.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18609.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12481.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22694,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22694,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16566.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18609.08
            },
            {
              "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": 18609.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14569.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14342.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "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": 19289.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22694,
              "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": 19289.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14569.55
            },
            {
              "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": 14569.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12481.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12481.7
            },
            {
              "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": 22694,
              "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": 22694,
              "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": 14773.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17020.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 22694
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "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": 18813.33
            },
            {
              "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": 18359.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17020.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16566.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22694,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22694,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14342.61
            },
            {
              "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": 19902.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14569.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14569.55
            },
            {
              "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": 18609.08
            },
            {
              "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": 14569.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19289.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 22694
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16566.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22694,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14773.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18609.08
            },
            {
              "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": 18609.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16566.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14342.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 22694
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6195.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 22694
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12481.7
            },
            {
              "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": 19970.72
            },
            {
              "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": 14342.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14773.79
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Biatain 5 in X 5 In",
      "code_information": [
        {
          "code": "PX-CH-CO3420",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.09,
          "discounted_cash": 3.96,
          "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": 3.91
            },
            {
              "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": 1.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.85
            },
            {
              "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": 3.96
            },
            {
              "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": 4.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.85
            },
            {
              "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": 6.09,
              "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": 5.18
            },
            {
              "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": 6.09,
              "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": 6.09,
              "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": 5.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.57
            },
            {
              "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": 5.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.91
            },
            {
              "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": 3.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.91
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 5.18
            },
            {
              "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": 3.85
            },
            {
              "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": 3.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "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": 6.09,
              "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": 6.09,
              "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": 6.09,
              "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": 3.91
            },
            {
              "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": 6.09,
              "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": 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": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 6.09,
              "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": 6.09,
              "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": 3.91
            },
            {
              "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": 4.93
            },
            {
              "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": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 5.36
            },
            {
              "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": 6.09,
              "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": 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": 3.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.91
            },
            {
              "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": 6.09,
              "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": 6.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 5.18
            },
            {
              "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": 6.09,
              "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": 3.96
            },
            {
              "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": 3.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 6.09,
              "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": 3.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "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": 5.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.09,
              "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": 6.09,
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 3.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 3.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.35
            },
            {
              "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": 6.09,
              "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": 3.35
            },
            {
              "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": 6.09,
              "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": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 6.09,
              "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": 6.09,
              "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": 3.35
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.91
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 6.09,
              "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": 5.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.18
            },
            {
              "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": 3.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 6.09,
              "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": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 3.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.18
            },
            {
              "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": 6.09,
              "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": 3.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.09,
              "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": 5.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "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": 4.99
            },
            {
              "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": 6.09,
              "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": 4.45
            },
            {
              "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": 6.09,
              "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": 3.96
            }
          ]
        }
      ]
    },
    {
      "description": "Ted Stocking Knee High X-Large/Regular",
      "code_information": [
        {
          "code": "PX-CH-KN7604",
          "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.26
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "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": "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "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": 9.83
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 36.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.3,
              "additional_payer_notes": "DMEPOS 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": 11.17,
              "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": 9.8
            },
            {
              "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 36.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.3,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.04
            },
            {
              "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 CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "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": 9.49
            },
            {
              "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": 9.16
            },
            {
              "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": "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 BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.27
            },
            {
              "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": 7.27
            },
            {
              "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": "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": "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": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "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": 9.16
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.26
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 36.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.3,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "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": "BUCKEYE COMMUNITY 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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "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": 7.17
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "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": "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 36.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 37.3,
              "additional_payer_notes": "DMEPOS 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": 7.06
            },
            {
              "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": "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": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "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 PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "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": 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": 6.2
            },
            {
              "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": 6.2
            },
            {
              "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"
            },
            {
              "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": "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": "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": "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": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "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": 8.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "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": 7.17
            },
            {
              "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": 7.17
            },
            {
              "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": "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": "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
            }
          ],
          "minimum": 36.93,
          "maximum": 36.93
        }
      ]
    },
    {
      "description": "HC I and D Hematoma Seroma Fluid",
      "code_information": [
        {
          "code": "PX-36100008",
          "type": "CDM"
        },
        {
          "code": "10140",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6858,
          "discounted_cash": 4457.7,
          "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": 4402.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4402.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5006.34
            },
            {
              "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": 1415.04,
              "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": 6858,
              "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": 4334.26
            },
            {
              "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": 6014.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4402.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 6858
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5623.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3771.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3771.9
            },
            {
              "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": 4334.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5685.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3771.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4334.26
            },
            {
              "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": 4402.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "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": 1415.04,
              "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": 4464.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3771.9
            },
            {
              "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": 1429.19,
              "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": 4402.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 1501.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "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": 3771.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3771.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4334.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5143.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 6858
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4464.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5548.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 5829.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 1485.79,
              "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": 5623.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 1443.91,
              "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": 5623.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5143.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4334.26
            },
            {
              "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": 1443.91,
              "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": 4464.56
            },
            {
              "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": 5623.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 1429.19,
              "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": 6858,
              "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": 4457.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4464.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5006.34
            },
            {
              "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": 4402.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 6858,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6858,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1415.04,
              "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": 4402.84
            },
            {
              "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": 4402.84
            },
            {
              "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": 5829.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3771.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 1443.91,
              "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": 5829.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "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": 1872.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 6858
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5623.56
            },
            {
              "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": 6014.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 6858,
              "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": 5623.56
            },
            {
              "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": 1485.79,
              "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": 6858,
              "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": 1415.04,
              "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": 1485.79,
              "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": 1429.19,
              "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": 6858,
              "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": 6858,
              "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": 6035.04
            },
            {
              "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": 4334.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "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": 6858,
              "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": 5829.3
            },
            {
              "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": 4402.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4464.56
            },
            {
              "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": 1429.19,
              "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": 5685.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 6858,
              "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": 5685.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5006.34
            },
            {
              "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": 5829.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "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": 5623.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 6858,
              "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": 5829.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6858,
              "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": 5006.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5006.34
            },
            {
              "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": 1429.19,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 6858
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4402.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5829.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 6858
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5623.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5143.5
            },
            {
              "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": 5006.34
            },
            {
              "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": 4334.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4334.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4402.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4402.84
            },
            {
              "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": 5548.12
            }
          ]
        }
      ]
    },
    {
      "description": "HC Debride Skin at Fx Site",
      "code_information": [
        {
          "code": "PX-36100012",
          "type": "CDM"
        },
        {
          "code": "11010",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1857,
          "discounted_cash": 1207.05,
          "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": 1192.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1192.19
            },
            {
              "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": 1502.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1578.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1021.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1578.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1857,
              "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": 1857,
              "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": 1192.19
            },
            {
              "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": 1522.74
            },
            {
              "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": 506.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1522.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1578.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1021.35
            },
            {
              "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": 1021.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1173.62
            },
            {
              "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": 1628.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1208.91
            },
            {
              "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": 1628.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1857,
              "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": 1208.91
            },
            {
              "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": 1522.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1539.45
            },
            {
              "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": 1522.74
            },
            {
              "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": 1857,
              "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": 1857,
              "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": 1857,
              "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": 1208.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1392.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1355.61
            },
            {
              "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": 1192.19
            },
            {
              "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": 1192.19
            },
            {
              "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": 1578.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1857,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1192.19
            },
            {
              "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": 1355.61
            },
            {
              "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": 1857,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1173.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1578.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1173.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1192.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1522.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1522.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1021.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1355.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1355.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1634.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1192.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1208.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1392.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1192.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1502.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1021.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1522.74
            },
            {
              "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": 1207.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1355.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1578.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1578.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1578.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1578.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1857,
              "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": 1021.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1578.45
            },
            {
              "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": 1173.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1192.19
            },
            {
              "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": 1857,
              "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": 1192.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1857,
              "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": 1173.62
            },
            {
              "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": 1192.19
            },
            {
              "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": 1208.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1522.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1355.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1392.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1173.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1173.62
            },
            {
              "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": 1173.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1539.45
            },
            {
              "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": 1539.45
            },
            {
              "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": 1578.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1578.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1021.35
            }
          ]
        }
      ]
    },
    {
      "description": "HC Inj Trigger Point 1 or 2 Muscles",
      "code_information": [
        {
          "code": "PX-36100082",
          "type": "CDM"
        },
        {
          "code": "20552",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2608,
          "discounted_cash": 1695.2,
          "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": 1674.34
            },
            {
              "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": 258.5,
              "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": 2608,
              "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": 2608,
              "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": 2608,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.43,
              "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": 1434.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "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": 276.54,
              "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": 2216.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1697.81
            },
            {
              "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": 261.09,
              "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": 258.5,
              "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": 261.09,
              "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": 2109.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2109.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1648.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "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": 1674.34
            },
            {
              "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": 1697.81
            },
            {
              "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": 2138.56
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 224
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.54,
              "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": 2216.8
            },
            {
              "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": 1674.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2608,
              "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": 1648.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "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": 2608,
              "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": 1903.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1903.84
            },
            {
              "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": 2216.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2608,
              "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": 1674.34
            },
            {
              "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": 2138.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1434.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1697.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2162.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 1674.34
            },
            {
              "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": 1674.34
            },
            {
              "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": 271.43,
              "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": 1674.34
            },
            {
              "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": 258.5,
              "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": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "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": 2287.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2608,
              "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": 276.54,
              "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": 1695.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1697.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 2608,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1903.84
            },
            {
              "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": 261.09,
              "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": 1956
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "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": 1648.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "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": 2287.22
            },
            {
              "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": 2608,
              "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": 711.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2138.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 261.09,
              "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": 1648.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2608
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2162.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1903.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 261.09,
              "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": 2608,
              "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": 2608,
              "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": 2138.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1648.26
            },
            {
              "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": 1434.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 271.43,
              "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": 1956
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2608,
              "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": 2295.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1903.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1903.84
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2608,
              "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": 2138.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2608,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1956
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 258.5,
              "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": 2608,
              "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": 2216.8
            },
            {
              "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": 2138.56
            },
            {
              "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": 2162.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1434.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1674.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2608,
              "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": 2216.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2216.8
            },
            {
              "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": 1697.81
            }
          ]
        }
      ]
    },
    {
      "description": "HC Bronchoscopy W Insert Bronch Valves Ini",
      "code_information": [
        {
          "code": "PX-36100151",
          "type": "CDM"
        },
        {
          "code": "31647",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5745,
          "discounted_cash": 3734.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3688.29
            },
            {
              "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": 4883.25
            },
            {
              "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": 5745,
              "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": 3159.75
            },
            {
              "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": 6033.34,
              "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": 5847.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 5745
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3159.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3688.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3688.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "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": 3688.29
            },
            {
              "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": 4710.9
            },
            {
              "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": 5038.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "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": 6272.28,
              "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": 4710.9
            },
            {
              "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": 5038.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 5745
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3688.29
            },
            {
              "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": 5745,
              "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": 3630.84
            },
            {
              "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": 5745,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 5745
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3159.75
            },
            {
              "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": 3688.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4710.9
            },
            {
              "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": 6139.71,
              "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": 4308.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3740
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3159.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 6033.34,
              "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": 4193.85
            },
            {
              "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": 6033.34,
              "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": 3740
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3688.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 5745
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3630.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 5745,
              "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": 6033.34,
              "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": 3740
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4710.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4710.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4193.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 5055.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4193.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5745,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4710.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 5966.67,
              "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": 1258.16
            },
            {
              "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": 6272.28,
              "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": 3740
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 5745,
              "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": 5745,
              "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": 3630.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3159.75
            },
            {
              "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": 4193.85
            },
            {
              "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": 5745,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 5847.34,
              "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": 5847.34,
              "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": 4647.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 3734.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3159.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4762.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 4883.25
            },
            {
              "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": 4762.61
            },
            {
              "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": 3688.29
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 5745
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "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": 4647.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4710.9
            },
            {
              "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": 1568.39
            },
            {
              "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": 3630.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 3688.29
            },
            {
              "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": 4710.9
            },
            {
              "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": 3688.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3688.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4762.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 5745,
              "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": 5966.67,
              "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": 3159.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4193.85
            },
            {
              "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": 4883.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3630.84
            },
            {
              "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": 3630.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4883.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4308.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4193.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3740
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3630.84
            },
            {
              "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": 5966.67,
              "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": 4308.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5745,
              "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": 5745,
              "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": 6033.34,
              "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": 3688.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3630.84
            },
            {
              "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": 5847.34,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Biopsy Pleura Percutaneous Needle",
      "code_information": [
        {
          "code": "PX-36100156",
          "type": "CDM"
        },
        {
          "code": "32400",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4996,
          "discounted_cash": 3247.4,
          "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": 3207.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4096.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3252.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2747.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4096.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 4996
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 4996,
              "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": 4996,
              "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": 3207.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "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": 4996,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 4996
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 4996
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4141.68
            },
            {
              "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": 3207.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3252.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 3157.47
            },
            {
              "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": 4381.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3647.08
            },
            {
              "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": 3252.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 4996
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1429.19,
              "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": 4246.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "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": 3207.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4096.72
            },
            {
              "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": 4246.6
            },
            {
              "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": 3157.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 4996,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 423
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "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": 4096.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 1443.91,
              "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": 3207.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 4246.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4246.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2747.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2747.8
            },
            {
              "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": 4096.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4096.72
            },
            {
              "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": 4096.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3747
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3647.08
            },
            {
              "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": 1485.79,
              "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": 1415.04,
              "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": 64.2,
              "estimated_amount": 3207.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3207.43
            },
            {
              "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": 4041.76
            },
            {
              "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": 4996,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 1429.19,
              "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": 3157.47
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1415.04,
              "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": 3747
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3747
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 4996,
              "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": 3207.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4041.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 3247.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2747.8
            },
            {
              "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": 4246.6
            },
            {
              "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": 4396.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 1485.79,
              "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": 3647.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3207.43
            },
            {
              "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": 1363.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 3207.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 1443.91,
              "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": 3157.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3647.08
            },
            {
              "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": 1429.19,
              "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": 4996,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4996,
              "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": 4246.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3207.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 4996
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3157.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3157.47
            },
            {
              "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": 3157.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1429.19,
              "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": 1415.04,
              "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": 4141.68
            },
            {
              "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": 3157.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 2747.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3647.08
            },
            {
              "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": 1429.19,
              "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": 1443.91,
              "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": 4246.6
            },
            {
              "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": 3207.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3252.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2747.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2747.8
            },
            {
              "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": 1485.79,
              "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": 4096.72
            },
            {
              "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": 4996,
              "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": 4381.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3647.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4141.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4996,
              "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": 3252.4
            },
            {
              "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": 1415.04,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Thoracostomy Tube Open",
      "code_information": [
        {
          "code": "PX-36100159",
          "type": "CDM"
        },
        {
          "code": "32551",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2736,
          "discounted_cash": 1778.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1756.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1997.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1997.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1729.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1781.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2736,
              "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": 1781.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "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": 1756.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1756.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2736,
              "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": 2736,
              "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": 1504.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2052
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1997.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2268.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1756.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2399.47
            },
            {
              "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": 2399.47
            },
            {
              "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": 1756.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2243.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2052
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1756.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1729.15
            },
            {
              "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": 1778.4
            },
            {
              "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": 1781.14
            },
            {
              "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": 2268.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1756.51
            },
            {
              "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": 2243.52
            },
            {
              "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": 1504.8
            },
            {
              "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": 2407.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1504.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "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": 1729.15
            },
            {
              "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": 1756.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1756.51
            },
            {
              "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": 746.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1729.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1504.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1997.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2736,
              "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": 1729.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 1781.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2243.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2268.14
            },
            {
              "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": 2243.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1729.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2243.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2243.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2213.42
            },
            {
              "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": 2736,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1997.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1729.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2736,
              "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": 2325.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2052
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 1781.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1504.8
            },
            {
              "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": 2736,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1504.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1504.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2325.6
            },
            {
              "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": 1756.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2243.52
            },
            {
              "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": 1729.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2243.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2325.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1756.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1997.28
            },
            {
              "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": 2325.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2736,
              "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": 2736,
              "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": 2736,
              "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": 2736,
              "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": 1756.51
            },
            {
              "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": 2213.42
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2736,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2736,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Pacer Ventricular W Lead",
      "code_information": [
        {
          "code": "PX-36100172",
          "type": "CDM"
        },
        {
          "code": "33207",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22288,
          "discounted_cash": 14487.2,
          "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": 14308.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16716
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "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": 14086.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 4011.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14509.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18030.99
            },
            {
              "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": 18276.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "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": 14086.02
            },
            {
              "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": 22288,
              "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": 22288,
              "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": 22288,
              "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": 9785.82,
              "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": 14086.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "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": 9510.03,
              "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": 18944.8
            },
            {
              "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": 9785.82,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 22288
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9413.03,
              "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": 22288,
              "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": 18944.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 22288
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 12258.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "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": 4881.07
            },
            {
              "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": 22288,
              "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": 14086.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "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": 9413.03,
              "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": 9413.03,
              "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": 9319.83,
              "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": 9319.83,
              "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": 4011.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 12258.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 9319.83,
              "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": 22288,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 22288
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9319.83,
              "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": 18944.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18476.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 18944.8
            },
            {
              "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": 22288,
              "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": 9510.03,
              "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": 14308.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18944.8
            },
            {
              "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": 19546.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 22288
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16716
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16270.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 14308.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14509.49
            },
            {
              "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": 6084.62
            },
            {
              "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": 12258.4
            },
            {
              "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": 9413.03,
              "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": 9510.03,
              "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": 18476.75
            },
            {
              "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": 18944.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 18944.8
            },
            {
              "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": 18944.8
            },
            {
              "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": 9785.82,
              "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": 16716
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 14308.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 22288,
              "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": 22288,
              "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": 22288,
              "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": 19613.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 22288
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "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": 14509.49
            },
            {
              "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": 18276.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "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": 14509.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14086.02
            },
            {
              "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": 19546.58
            },
            {
              "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": 14308.9
            },
            {
              "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": 18030.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12258.4
            },
            {
              "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": 9413.03,
              "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": 22288,
              "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": 22288,
              "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": 18944.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14509.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18276.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14308.9
            },
            {
              "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": 18276.16
            },
            {
              "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": 14487.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18476.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ins Cath 2nd+ Order Ren Art Uni W Img",
      "code_information": [
        {
          "code": "PX-36100277",
          "type": "CDM"
        },
        {
          "code": "36253",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9486,
          "discounted_cash": 6165.9,
          "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": 6090.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5995.15
            },
            {
              "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": 9486,
              "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": 9486,
              "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": 8319.22
            },
            {
              "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": 4894.14,
              "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": 6175.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7114.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6175.39
            },
            {
              "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": 7778.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6924.78
            },
            {
              "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": 4844.22,
              "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": 5217.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5217.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6090.01
            },
            {
              "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": 4796.26,
              "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": 8063.1
            },
            {
              "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": 8347.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5217.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 9486,
              "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": 4894.14,
              "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": 8063.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 9486
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6090.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5995.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 9486
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7674.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7778.52
            },
            {
              "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": 9486,
              "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": 8063.1
            },
            {
              "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": 6924.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7114.5
            },
            {
              "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": 5995.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7114.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6090.01
            },
            {
              "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": 5036.07,
              "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": 6924.78
            },
            {
              "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": 5036.07,
              "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": 7863.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7778.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7778.52
            },
            {
              "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": 4796.26,
              "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": 9486,
              "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": 8063.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6090.01
            },
            {
              "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": 2589.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 9486,
              "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": 9486,
              "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": 9486,
              "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": 5217.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "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": 6090.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6175.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7778.52
            },
            {
              "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": 7778.52
            },
            {
              "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": 5995.15
            },
            {
              "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": 6165.9
            },
            {
              "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": 4844.22,
              "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": 5995.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 4894.14,
              "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": 9486,
              "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": 6175.39
            },
            {
              "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": 5217.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7863.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6090.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6175.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4844.22,
              "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": 8063.1
            },
            {
              "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": 4796.26,
              "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": 7863.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5995.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 6924.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6924.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 9486,
              "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": 6090.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 8063.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5995.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1707.48
            },
            {
              "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": 6090.01
            },
            {
              "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": 7778.52
            },
            {
              "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": 4844.22,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 9486
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "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": 8319.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6090.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 9486
            },
            {
              "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": 2077.43
            },
            {
              "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": 5036.07,
              "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": 5217.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 9486,
              "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": 6090.01
            },
            {
              "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": 1707.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5217.3
            },
            {
              "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": 4844.22,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 9486
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6090.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8063.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7778.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5995.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9486,
              "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": 7674.17
            },
            {
              "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": 4796.26,
              "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": 6924.78
            }
          ]
        }
      ]
    },
    {
      "description": "HC Endovenous Ablation Ext Laser 2nd+ Veins",
      "code_information": [
        {
          "code": "PX-36100286",
          "type": "CDM"
        },
        {
          "code": "36479",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5706,
          "discounted_cash": 3708.9,
          "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": 3663.25
            },
            {
              "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": 4616.15
            },
            {
              "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": 4850.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3714.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4678.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3138.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4165.38
            },
            {
              "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": 5706,
              "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": 3663.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3606.19
            },
            {
              "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": 5004.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 4279.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 3663.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 3663.25
            },
            {
              "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": 5706,
              "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": 4850.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5706,
              "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": 5706,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "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": 4678.92
            },
            {
              "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": 3606.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3606.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 5706,
              "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": 5706,
              "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": 3663.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3606.19
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5706,
              "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": 5706,
              "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": 5706,
              "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": 4165.38
            },
            {
              "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": 5706,
              "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": 4850.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 4850.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3606.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 5706,
              "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": 4165.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 3663.25
            },
            {
              "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": 5706,
              "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": 3663.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3714.61
            },
            {
              "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": 3714.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4616.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3714.61
            },
            {
              "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": 5706,
              "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": 3606.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 5706,
              "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": 5004.16
            },
            {
              "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": 1249.61
            },
            {
              "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": 3663.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3138.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3606.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4678.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3663.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4165.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 3138.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3138.3
            },
            {
              "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": 5706,
              "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": 5706,
              "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": 5706,
              "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": 5706,
              "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": 5706,
              "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": 4678.92
            },
            {
              "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": 4730.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4279.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4730.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5706,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3138.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "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": 5706,
              "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": 4165.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4279.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3663.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3138.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5706,
              "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": 5706,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "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": 5706,
              "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": 5706,
              "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": 5021.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4850.1
            },
            {
              "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": 4678.92
            },
            {
              "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": 4678.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4730.27
            },
            {
              "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": 3138.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5706,
              "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": 5706,
              "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": 5706,
              "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": 4850.1
            },
            {
              "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": 5706,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4678.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4678.92
            },
            {
              "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": 1557.74
            },
            {
              "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": 3606.19
            },
            {
              "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": 3708.9
            },
            {
              "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": 5706,
              "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": 4165.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3663.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3663.25
            },
            {
              "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": 3714.61
            }
          ]
        }
      ]
    },
    {
      "description": "HC Replace Tunneled Cvc",
      "code_information": [
        {
          "code": "PX-36100304",
          "type": "CDM"
        },
        {
          "code": "36581",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10080,
          "discounted_cash": 6552,
          "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": 6471.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 6471.36
            },
            {
              "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": 2723.19,
              "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": 6370.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 8568
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7358.4
            },
            {
              "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": 8568
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6370.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 5544
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 10080
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6471.36
            },
            {
              "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": 8840.16
            },
            {
              "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": 2751.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8568
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 8568
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2838.77,
              "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": 8356.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1814.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 10080,
              "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": 7358.4
            },
            {
              "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": 2921.09,
              "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": 8154.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6471.36
            },
            {
              "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": 10080,
              "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": 8568
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5544
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5544
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7358.4
            },
            {
              "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": 2838.77,
              "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": 6471.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8154.72
            },
            {
              "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": 1814.4
            },
            {
              "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": 6471.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8265.6
            },
            {
              "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": 6370.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6471.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6471.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6562.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 10080,
              "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": 10080,
              "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": 2781.99,
              "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": 8568
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5544
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 8568
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6562.08
            },
            {
              "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": 2781.99,
              "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": 2838.77,
              "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": 5544
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 8568
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8840.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 10080
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6471.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8265.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7358.4
            },
            {
              "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": 10080,
              "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": 8265.6
            },
            {
              "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": 6370.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7560
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8568
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 10080,
              "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": 8568
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8356.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7560
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6370.56
            },
            {
              "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": 6471.36
            },
            {
              "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": 6471.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7358.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5544
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2921.09,
              "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": 2723.19,
              "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": 8265.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 10080
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8568
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 6370.56
            },
            {
              "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": 2207.52
            },
            {
              "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": 8265.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 6370.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 8568
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5544
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 8870.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8568
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6562.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8265.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10080,
              "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": 10080,
              "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": 6562.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 10080
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 10080
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8356.32
            },
            {
              "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": 6552
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6370.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6562.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7358.4
            },
            {
              "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": 8265.6
            },
            {
              "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": 8265.6
            },
            {
              "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": 2859.35,
              "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": 7560
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2809.81,
              "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": 10080,
              "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": 8568
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6471.36
            }
          ]
        }
      ]
    },
    {
      "description": "HC Collect Bld Spec Impl Vad",
      "code_information": [
        {
          "code": "PX-36100309",
          "type": "CDM"
        },
        {
          "code": "36591",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 794,
          "discounted_cash": 516.1,
          "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": 509.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 658.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 794,
              "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": 440.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "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": 509.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.81
            },
            {
              "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": 698.72
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "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": 658.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 794,
              "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": 651.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 642.35
            },
            {
              "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": 696.34
            },
            {
              "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": 509.75
            },
            {
              "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": 109.13,
              "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": 436.7
            },
            {
              "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": 440.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "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": 516.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.89
            },
            {
              "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": 696.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "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": 117.06,
              "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": 501.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "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": 794,
              "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": 674.9
            },
            {
              "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": 579.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 516.1
            },
            {
              "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": 509.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 658.23
            },
            {
              "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": 111.49,
              "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": 509.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 794
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 794,
              "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": 509.75
            },
            {
              "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": 509.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 113.77,
              "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": 651.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.89
            },
            {
              "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": 651.08
            },
            {
              "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": 501.81
            },
            {
              "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": 111.49,
              "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": 794,
              "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": 436.7
            },
            {
              "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": 113.77,
              "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": 674.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 794,
              "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": 794,
              "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": 794,
              "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": 794,
              "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": 674.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.7
            },
            {
              "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": 112.6,
              "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": 516.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 674.9
            },
            {
              "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": 642.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "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": 112.6,
              "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": 674.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.9
            },
            {
              "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": 112.6,
              "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": 794,
              "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": 113.77,
              "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": 516.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "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": 501.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "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": 651.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "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": 794,
              "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": 117.06,
              "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": 112.6,
              "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": 112.6,
              "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": 794,
              "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": 440.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 651.08
            },
            {
              "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": 794,
              "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": 674.9
            },
            {
              "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": 109.13,
              "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": 117.06,
              "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": 794,
              "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": 674.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 794,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 794,
          "payers_information": [
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 216.76
            }
          ]
        }
      ]
    },
    {
      "description": "HC Rem Intraluminal Obscructive Material",
      "code_information": [
        {
          "code": "PX-36100313",
          "type": "CDM"
        },
        {
          "code": "36596",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2386,
          "discounted_cash": 1550.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1531.81
            },
            {
              "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": 1930.27
            },
            {
              "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": 651.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1741.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1531.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1553.29
            },
            {
              "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": 1956.52
            },
            {
              "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": 2099.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1507.95
            },
            {
              "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": 1741.78
            },
            {
              "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": 2386,
              "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": 2386,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1956.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1741.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1977.99
            },
            {
              "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": 1553.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 2028.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1956.52
            },
            {
              "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": 1507.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 2386,
              "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": 1977.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 2386,
              "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": 1312.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1531.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1956.52
            },
            {
              "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": 2028.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1553.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1312.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1741.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1741.78
            },
            {
              "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": 1550.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "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": 2092.52
            },
            {
              "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": 2028.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1789.5
            },
            {
              "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": 1956.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "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": 2386,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1789.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1507.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1531.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1531.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1507.95
            },
            {
              "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": 1531.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1312.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1741.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1312.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1553.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1956.52
            },
            {
              "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": 2386,
              "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": 2386,
              "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": 2386,
              "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": 2386,
              "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": 2028.1
            },
            {
              "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": 1531.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "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": 1507.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1507.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1531.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1507.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1531.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1531.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1956.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2386,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2028.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1507.95
            },
            {
              "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": 1312.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1531.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1531.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1553.29
            },
            {
              "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": 2092.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 2386,
              "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": 1312.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2386,
              "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": 1977.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1930.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1956.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1312.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1789.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Transcath Stent Cca WO Eps",
      "code_information": [
        {
          "code": "PX-36100351",
          "type": "CDM"
        },
        {
          "code": "37216",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18523,
          "discounted_cash": 12039.95,
          "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": 11891.77
            },
            {
              "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": 12058.47
            },
            {
              "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": 11706.54
            },
            {
              "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": 16244.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11706.54
            },
            {
              "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": 16300.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11706.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 12039.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10187.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15188.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13892.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12058.47
            },
            {
              "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": 15188.86
            },
            {
              "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": 11706.54
            },
            {
              "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": 18523,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "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": 18523,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 12058.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 11706.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 15744.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10187.65
            },
            {
              "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": 11891.77
            },
            {
              "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": 13521.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15355.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11891.77
            },
            {
              "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": 11891.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11891.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12058.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 18523,
              "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": 18523,
              "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": 11706.54
            },
            {
              "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": 10187.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13521.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10187.65
            },
            {
              "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": 11891.77
            },
            {
              "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": 11891.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "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": 11706.54
            },
            {
              "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": 18523,
              "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": 15188.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15188.86
            },
            {
              "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": 15188.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10187.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 15744.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11891.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10187.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15355.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 15188.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15188.86
            },
            {
              "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": 5056.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 18523,
              "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": 11891.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11891.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13521.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13892.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11706.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11891.77
            },
            {
              "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": 18523,
              "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": 13892.25
            },
            {
              "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": 16244.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14985.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10187.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "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": 15355.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18523,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 12058.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15188.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13521.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 18523,
              "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": 15744.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 18523,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14985.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11891.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18523,
              "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": 18523,
              "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": 13521.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15744.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13521.79
            }
          ]
        }
      ]
    },
    {
      "description": "HC Revasc/Endo Tibioper W Stnt&Ather",
      "code_information": [
        {
          "code": "PX-36100363",
          "type": "CDM"
        },
        {
          "code": "37231",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34432,
          "discounted_cash": 22380.8,
          "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": 22105.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18937.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22415.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28234.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15304.39,
              "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": 25135.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18937.6
            },
            {
              "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": 16069.61,
              "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": 15304.39,
              "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": 34432,
              "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": 34432,
              "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": 29267.2
            },
            {
              "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": 25135.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28544.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 16069.61,
              "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": 25135.36
            },
            {
              "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": 34432,
              "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": 22105.34
            },
            {
              "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": 22105.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18937.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 34432
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25135.36
            },
            {
              "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": 15457.43,
              "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": 30196.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 6197.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25824
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25135.36
            },
            {
              "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": 29267.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 22105.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18937.6
            },
            {
              "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": 15457.43,
              "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": 29267.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28544.13
            },
            {
              "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": 7540.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18937.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22105.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22105.34
            },
            {
              "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": 16069.61,
              "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": 28234.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 34432
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "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": 28544.13
            },
            {
              "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": 15457.43,
              "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": 29267.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21761.02
            },
            {
              "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": 22415.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "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": 15457.43,
              "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": 21761.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 28234.24
            },
            {
              "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": 28234.24
            },
            {
              "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": 28234.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "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": 6197.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25824
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25135.36
            },
            {
              "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": 22415.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 34432,
              "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": 30300.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21761.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 29267.2
            },
            {
              "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": 22105.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22105.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28234.24
            },
            {
              "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": 34432,
              "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": 28234.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21761.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 34432,
              "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": 34432,
              "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": 21761.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22415.23
            },
            {
              "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": 18937.6
            },
            {
              "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": 15457.43,
              "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": 30196.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22105.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25824
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15304.39,
              "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": 34432,
              "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": 15616.72,
              "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": 22105.34
            },
            {
              "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": 9399.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 34432
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 34432
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29267.2
            },
            {
              "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": 34432,
              "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": 15304.39,
              "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": 34432,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 34432
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 22380.8
            },
            {
              "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": 22105.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21761.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21761.02
            },
            {
              "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": 21761.02
            },
            {
              "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": 15616.72,
              "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": 15616.72,
              "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": 18937.6
            },
            {
              "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": 27855.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22415.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27855.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28234.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34432,
              "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": 22105.34
            }
          ]
        }
      ]
    },
    {
      "description": "HC Rem Ureteral Stent Transurethral",
      "code_information": [
        {
          "code": "PX-36100446",
          "type": "CDM"
        },
        {
          "code": "50386",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7373,
          "discounted_cash": 4792.45,
          "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": 4733.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4055.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4659.74
            },
            {
              "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": 7373,
              "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": 7373,
              "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": 6045.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4055.15
            },
            {
              "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": 4733.47
            },
            {
              "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": 4792.45
            },
            {
              "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": 4659.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "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": 6267.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 7373,
              "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": 5382.29
            },
            {
              "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": 6112.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4055.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "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": 6488.24
            },
            {
              "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": 4055.15
            },
            {
              "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": 4733.47
            },
            {
              "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": 4733.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "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": 7373,
              "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": 5382.29
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7373,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4659.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4659.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4733.47
            },
            {
              "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": 4733.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4659.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5964.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6045.86
            },
            {
              "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": 4659.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5529.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4733.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4733.47
            },
            {
              "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": 5382.29
            },
            {
              "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": 4799.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4733.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4733.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4799.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 7373,
              "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": 4055.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4055.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4659.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 6267.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4733.47
            },
            {
              "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": 6045.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 5382.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 4733.47
            },
            {
              "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": 4659.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4799.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5382.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5529.75
            },
            {
              "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": 6466.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 7373,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5382.29
            },
            {
              "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": 6466.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 7373,
              "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": 7373,
              "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": 4799.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 7373,
              "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": 6045.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6112.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6045.86
            },
            {
              "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": 5964.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6112.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 7373,
              "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": 7373,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5529.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6267.05
            },
            {
              "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": 2012.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "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": 6267.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6045.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7373,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4055.15
            },
            {
              "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": 4799.82
            },
            {
              "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": 7373,
              "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": 6267.05
            },
            {
              "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": 6045.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6045.86
            }
          ]
        }
      ]
    },
    {
      "description": "Cryoablation Renal Tumor Unilat",
      "code_information": [
        {
          "code": "PX-36100459",
          "type": "CDM"
        },
        {
          "code": "50593",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14514,
          "discounted_cash": 9434.1,
          "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": 9317.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11901.48
            },
            {
              "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": 9074.04,
              "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": 14514,
              "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": 14514,
              "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": 3178.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 12336.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7982.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10595.22
            },
            {
              "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": 9172.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 9172.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10595.22
            },
            {
              "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": 9074.04,
              "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": 9074.04,
              "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": 12032.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9448.61
            },
            {
              "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": 11901.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12032.11
            },
            {
              "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": 7982.7
            },
            {
              "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": 9317.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 9172.85
            },
            {
              "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": 8973.78,
              "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": 12032.11
            },
            {
              "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": 8794.3,
              "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": 10595.22
            },
            {
              "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": 12336.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11901.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 14514
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10885.5
            },
            {
              "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": 9433.41,
              "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": 12728.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9448.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "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": 9317.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7982.7
            },
            {
              "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": 9433.41,
              "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": 9172.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9172.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "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": 12772.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7982.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11901.48
            },
            {
              "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": 9234.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9317.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 14514,
              "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": 14514,
              "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": 8973.78,
              "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": 14514,
              "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": 9448.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 11901.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 14514
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11741.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9317.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9317.99
            },
            {
              "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": 11901.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7982.7
            },
            {
              "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": 12728.78
            },
            {
              "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": 8973.78,
              "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": 7982.7
            },
            {
              "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": 9317.99
            },
            {
              "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": 11741.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 14514
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10595.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9172.85
            },
            {
              "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": 9172.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9317.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10885.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9317.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 14514,
              "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": 14514,
              "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": 10595.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11901.48
            },
            {
              "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": 14514,
              "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": 10885.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9172.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "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": 8984.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 14514
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2612.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 14514,
              "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": 9074.04,
              "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": 3962.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 14514
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "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": 12336.9
            },
            {
              "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": 9434.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9317.99
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8984.2,
              "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": 8794.3,
              "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": 14514,
              "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": 10595.22
            },
            {
              "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": 9074.04,
              "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": 9317.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9448.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7982.7
            },
            {
              "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": 9317.99
            },
            {
              "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": 9448.61
            },
            {
              "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": 11901.48
            },
            {
              "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": 2612.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12336.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14514,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Irrig Bladder Simple and or Instillation",
      "code_information": [
        {
          "code": "PX-36100466",
          "type": "CDM"
        },
        {
          "code": "51700",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1591,
          "discounted_cash": 1034.15,
          "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": 1021.42
            },
            {
              "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": 1287.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1591,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1021.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1287.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 875.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1161.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1005.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1035.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1005.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 875.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "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": 1035.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1035.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1352.35
            },
            {
              "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": 1021.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1021.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1304.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 875.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1005.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1591,
              "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": 1591,
              "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": 1161.43
            },
            {
              "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": 1352.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1021.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1352.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1318.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1591,
              "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": 1021.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1193.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1161.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1304.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 875.05
            },
            {
              "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": 875.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "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": 1304.62
            },
            {
              "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": 434.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1591,
              "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": 1591,
              "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": 1161.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1161.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1021.42
            },
            {
              "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": 1021.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1035.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "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": 1161.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1021.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1304.62
            },
            {
              "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": 1395.31
            },
            {
              "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": 1021.42
            },
            {
              "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": 1304.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 875.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 875.05
            },
            {
              "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": 1400.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1304.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1193.25
            },
            {
              "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": 1591,
              "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": 1304.62
            },
            {
              "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": 1005.51
            },
            {
              "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": 1005.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "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": 1591,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1021.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1005.51
            },
            {
              "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": 1591,
              "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": 1591,
              "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": 1591,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1005.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1591,
              "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": 1591,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1318.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1021.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1318.94
            },
            {
              "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": 1034.15
            },
            {
              "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": 1304.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1591,
              "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": 1005.51
            },
            {
              "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": 1395.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1352.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1035.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1193.25
            },
            {
              "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": 1591,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Removal Subq Reservoir or Pump",
      "code_information": [
        {
          "code": "PX-36100533",
          "type": "CDM"
        },
        {
          "code": "62365",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18383,
          "discounted_cash": 11948.95,
          "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": 11801.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15074.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10110.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10110.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13419.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11618.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15074.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            },
            {
              "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": 11967.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11967.33
            },
            {
              "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": 11618.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 18383,
              "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": 18383,
              "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": 11801.89
            },
            {
              "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": 14871.85
            },
            {
              "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": 15074.06
            },
            {
              "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": 16121.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13787.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 13419.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15074.06
            },
            {
              "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": 11618.06
            },
            {
              "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": 18383,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18383,
              "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": 13419.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11801.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11618.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11801.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15074.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15239.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 15239.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10110.65
            },
            {
              "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": 11801.89
            },
            {
              "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": 15074.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13787.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 18383,
              "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": 18383,
              "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": 15239.51
            },
            {
              "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": 11618.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 18383,
              "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": 18383,
              "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": 15074.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14871.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 11948.95
            },
            {
              "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": 18383,
              "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": 18383,
              "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": 11801.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11801.89
            },
            {
              "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": 11801.89
            },
            {
              "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": 15074.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11618.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10110.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11967.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10110.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13419.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11618.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 13419.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11801.89
            },
            {
              "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": 15625.55
            },
            {
              "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": 16121.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 18383,
              "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": 18383,
              "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": 15625.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11618.06
            },
            {
              "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": 10110.65
            },
            {
              "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": 11801.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11967.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10110.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13419.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18383,
              "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": 15625.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11801.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18383,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13787.25
            },
            {
              "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": 11967.33
            },
            {
              "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": 16177.04
            },
            {
              "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": 15625.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11801.89
            },
            {
              "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": 5018.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15625.55
            }
          ]
        }
      ]
    },
    {
      "description": "Injection of Anethetic or Steroid Into Sacroiliac Joint",
      "code_information": [
        {
          "code": "PX-36100619",
          "type": "CDM"
        },
        {
          "code": "G0260",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4649,
          "discounted_cash": 3021.85,
          "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": 2984.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3393.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3486.75
            },
            {
              "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": 633.75,
              "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": 3393.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3812.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3854.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3486.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2938.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 2556.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2556.95
            },
            {
              "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": 609.61,
              "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": 3812.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3486.75
            },
            {
              "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": 1269.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 4649,
              "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": 4649,
              "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": 4649,
              "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": 3021.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2984.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 2938.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "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": 3951.65
            },
            {
              "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": 603.57,
              "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": 2984.66
            },
            {
              "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": 2984.66
            },
            {
              "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": 2984.66
            },
            {
              "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": 2938.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3393.77
            },
            {
              "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": 4649,
              "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": 2984.66
            },
            {
              "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": 3812.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "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": 4649,
              "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": 3026.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "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": 609.61,
              "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": 2938.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2938.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "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": 2556.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3854.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 4077.17
            },
            {
              "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": 615.89,
              "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": 3393.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3393.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2984.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2984.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3026.5
            },
            {
              "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": 3026.5
            },
            {
              "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": 3951.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 2984.66
            },
            {
              "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": 603.57,
              "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": 3951.65
            },
            {
              "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": 4649,
              "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": 603.57,
              "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": 4649,
              "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": 615.89,
              "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": 3812.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 3951.65
            },
            {
              "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": 4077.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2938.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 2938.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 609.61,
              "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": 609.61,
              "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": 3951.65
            },
            {
              "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": 4091.12
            },
            {
              "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": 3761.04
            },
            {
              "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": 633.75,
              "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": 2984.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3951.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2556.95
            },
            {
              "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": 3854.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3812.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2984.66
            },
            {
              "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": 3026.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2938.17
            },
            {
              "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": 609.61,
              "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": 4649,
              "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": 2984.66
            },
            {
              "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": 3812.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2556.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2556.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 3393.77
            },
            {
              "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": 4649,
              "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": 4649,
              "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": 3812.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3812.18
            },
            {
              "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": 633.75,
              "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": 3761.04
            },
            {
              "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": 1018.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4649,
              "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": 3026.5
            },
            {
              "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": 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": 615.89,
              "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": 4649,
              "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": 2556.95
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ecmo Initial Day Veno-Arterial",
      "code_information": [
        {
          "code": "PX-36000059",
          "type": "CDM"
        },
        {
          "code": "33947",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41522,
          "discounted_cash": 26989.3,
          "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": 26657.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "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": 36414.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41522,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34048.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "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": 26657.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34048.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34048.04
            },
            {
              "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": 26241.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "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": 33591.3
            },
            {
              "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": 26241.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34048.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26241.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "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": 11335.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 41522
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 36539.36
            },
            {
              "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": 41522,
              "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": 26657.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41522,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34048.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22837.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26241.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "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": 27030.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27030.82
            },
            {
              "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": 22837.1
            },
            {
              "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": 41522,
              "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": 30311.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41522,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31141.5
            },
            {
              "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": 26657.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31141.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26241.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41522,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41522,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30311.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30311.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 41522
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30311.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26241.9
            },
            {
              "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": 26989.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22837.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41522,
              "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": 34421.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "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": 36414.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22837.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "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": 34048.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34421.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22837.1
            },
            {
              "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": 34421.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41522,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 41522
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "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": 27030.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27030.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33591.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31141.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27030.82
            },
            {
              "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": 34048.04
            },
            {
              "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": 41522,
              "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": 26241.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 41522
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22837.1
            },
            {
              "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": 30311.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26241.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26657.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34048.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30311.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22837.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 41522
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35293.7
            }
          ]
        }
      ]
    },
    {
      "description": "\"Foam Drsg Bordered Triact 4\"\" X 4\"\" With 2.5\"\" X 2.5\"\" Pad\"",
      "code_information": [
        {
          "code": "PX-CH-HO550762",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.67,
          "discounted_cash": 3.69,
          "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": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.64
            },
            {
              "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": 5.67,
              "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": 5.67,
              "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": 3.58
            },
            {
              "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": 4.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 3.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.14
            },
            {
              "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": 4.65
            },
            {
              "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": 4.7
            },
            {
              "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": 4.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.67
            },
            {
              "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": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 4.82
            },
            {
              "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": 3.15
            },
            {
              "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": 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": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.14
            },
            {
              "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": 5.67,
              "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": 5.67,
              "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": 5.67,
              "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": 3.64
            },
            {
              "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": 3.69
            },
            {
              "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": 3.58
            },
            {
              "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": 5.67,
              "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": 3.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.65
            },
            {
              "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": 1.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.12
            },
            {
              "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": 5.67,
              "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": 5.67,
              "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": 4.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.67,
              "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": 3.12
            },
            {
              "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": 5.67,
              "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": 4.65
            },
            {
              "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": 5.67,
              "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": 5.67,
              "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": 4.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 4.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 5.67,
              "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": 4.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 5.67,
              "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": 5.67,
              "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": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 5.67,
              "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": 3.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 4.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.58
            },
            {
              "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": 3.64
            },
            {
              "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": 5.67,
              "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": 5.67,
              "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": 5.67,
              "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": 5.67,
              "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": 3.15
            },
            {
              "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": 5.67,
              "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": 3.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.14
            },
            {
              "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": 5.67,
              "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": 3.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.14
            },
            {
              "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": 5.67,
              "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": 3.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.69
            },
            {
              "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": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.65
            },
            {
              "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": 5.67,
              "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": 3.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.69
            },
            {
              "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": 5.67,
              "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": 5.67,
              "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": 4.14
            },
            {
              "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": 4.97
            },
            {
              "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": 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": 3.64
            },
            {
              "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": 3.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 4.7
            },
            {
              "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": 5.67,
              "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": 4.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 4.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.67,
              "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": 4.82
            },
            {
              "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": 5.67,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mammogram Diag Unilat Digital W Cad",
      "code_information": [
        {
          "code": "PX-40100005",
          "type": "CDM"
        },
        {
          "code": "77065",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 742,
          "discounted_cash": 482.3,
          "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": 476.36
            },
            {
              "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": 476.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 608.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.94
            },
            {
              "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": 742,
              "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": 408.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 476.36
            },
            {
              "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": 630.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 742,
              "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": 468.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "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": 742,
              "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": 742,
              "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": 742,
              "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": 476.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 541.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "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": 411.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 556.5
            },
            {
              "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": 541.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 541.66
            },
            {
              "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": 615.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 408.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 556.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 600.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 483.04
            },
            {
              "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": 608.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "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": 468.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 652.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 608.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 476.36
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "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": 650.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 556.5
            },
            {
              "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": 650.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 476.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 608.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "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": 742,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "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": 608.44
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 79.49,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 83.46,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 742,
              "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": 541.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "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": 483.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 541.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 742
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 408.1
            },
            {
              "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": 202.57
            },
            {
              "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": 742,
              "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": 476.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 408.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 476.36
            },
            {
              "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": 600.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 476.36
            },
            {
              "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": 483.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 483.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "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": 742,
              "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": 630.7
            },
            {
              "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": 476.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 476.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "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": 468.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "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": 482.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 608.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 408.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 541.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 411.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 615.12
            },
            {
              "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": 411.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 408.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 742,
              "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": 742,
              "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": 608.44
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 615.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.94
            },
            {
              "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": 630.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "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": 742,
              "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": 411.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 630.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 483.04
            },
            {
              "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": 608.44
            },
            {
              "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": 468.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 742,
              "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": 408.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "case rate",
              "standard_charge_dollar": 86.76,
              "estimated_amount": 86.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 742,
              "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": 476.36
            }
          ],
          "minimum": 79.49,
          "maximum": 86.76
        }
      ]
    },
    {
      "description": "HC US Transvaginal",
      "code_information": [
        {
          "code": "PX-40200029",
          "type": "CDM"
        },
        {
          "code": "76830",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 648,
          "discounted_cash": 421.2,
          "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": 416.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "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": 648,
              "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": 648,
              "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": 416.02
            },
            {
              "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": 100.75,
              "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": 550.8
            },
            {
              "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": 100.75,
              "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": 648,
              "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": 531.36
            },
            {
              "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": 100.75,
              "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": 421.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "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": 531.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 648,
              "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": 550.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "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": 96.91,
              "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": 356.4
            },
            {
              "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": 96.91,
              "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": 359.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 409.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "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": 473.04
            },
            {
              "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": 550.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "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": 648,
              "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": 176.9
            },
            {
              "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": 95.95,
              "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": 409.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 421.85
            },
            {
              "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": 648,
              "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": 524.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 486
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 648,
              "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": 550.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "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": 568.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "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": 359.64
            },
            {
              "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": 537.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 537.19
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 421.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "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": 95.95,
              "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": 356.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "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": 531.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 486
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 95.95,
              "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": 648,
              "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": 550.8
            },
            {
              "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": 416.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 416.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 524.23
            },
            {
              "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": 531.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 648,
              "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": 96.91,
              "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": 96.91,
              "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": 648,
              "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": 550.8
            },
            {
              "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": 570.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 486
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 550.8
            },
            {
              "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": 416.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "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": 416.02
            },
            {
              "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": 421.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 409.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 97.91,
              "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": 550.8
            },
            {
              "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": 96.91,
              "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": 648,
              "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": 359.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 531.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 550.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 97.91,
              "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": 359.64
            },
            {
              "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": 648,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 648
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 97.91,
              "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": 421.2
            },
            {
              "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": 409.54
            },
            {
              "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": 568.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 537.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 473.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 416.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 356.4
            },
            {
              "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": 356.4
            },
            {
              "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": 95.95,
              "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": 416.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 648,
              "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": 648,
              "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": 648,
              "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": 648,
              "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": 550.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 421.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC US for Aaa Screening",
      "code_information": [
        {
          "code": "PX-40200051",
          "type": "CDM"
        },
        {
          "code": "76706",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 228,
          "discounted_cash": 148.2,
          "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": 146.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 97.91,
              "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": 193.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 189.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.44
            },
            {
              "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": 96.91,
              "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": 184.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.8
            },
            {
              "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": 199.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 193.8
            },
            {
              "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": 200.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.1
            },
            {
              "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": 228,
              "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": 193.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 228
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 189.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.44
            },
            {
              "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": 146.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.38
            },
            {
              "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": 186.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 100.75,
              "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": 125.4
            },
            {
              "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": 95.95,
              "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": 228,
              "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": 228,
              "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": 148.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.8
            },
            {
              "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": 228,
              "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": 146.38
            },
            {
              "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": 184.45
            },
            {
              "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": 126.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 146.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 228,
              "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": 193.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.4
            },
            {
              "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": 166.44
            },
            {
              "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": 95.95,
              "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": 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": 146.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 189.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 193.8
            },
            {
              "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": 96.91,
              "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": 193.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.44
            },
            {
              "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": 95.95,
              "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": 96.91,
              "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": 100.75,
              "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": 148.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.8
            },
            {
              "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": 97.91,
              "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": 193.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 126.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.1
            },
            {
              "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": 97.91,
              "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": 148.43
            },
            {
              "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": 228,
              "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": 228,
              "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": 228,
              "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": 95.95,
              "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": 146.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.96
            },
            {
              "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": 62.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.1
            },
            {
              "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": 199.96
            },
            {
              "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": 126.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 228,
              "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": 193.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.4
            },
            {
              "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": 96.91,
              "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": 148.43
            },
            {
              "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": 186.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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,
              "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": 125.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 228,
              "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": 193.8
            },
            {
              "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": 148.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.96
            },
            {
              "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": 96.91,
              "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": 228,
              "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": 146.38
            },
            {
              "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": 146.38
            },
            {
              "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": 186.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171
            },
            {
              "payer_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,
              "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": 146.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.1
            },
            {
              "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": 144.1
            },
            {
              "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": 144.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228,
              "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": 228,
              "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": 125.4
            },
            {
              "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": 100.75,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pet Imaging W CT Whole Body",
      "code_information": [
        {
          "code": "PX-40400005",
          "type": "CDM"
        },
        {
          "code": "78816",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9232,
          "discounted_cash": 6000.8,
          "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": 5926.94
            },
            {
              "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": 9232,
              "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": 8124.16
            },
            {
              "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": 5926.94
            },
            {
              "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": 1433.71,
              "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": 6739.36
            },
            {
              "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": 1379.09,
              "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": 5926.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7570.24
            },
            {
              "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": 1433.71,
              "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": 9232
            },
            {
              "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": 9232,
              "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": 6010.03
            },
            {
              "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": 7570.24
            },
            {
              "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": 5926.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 9232,
              "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": 1379.09,
              "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": 5123.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7570.24
            },
            {
              "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": 5834.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 9232,
              "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": 9232,
              "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": 8096.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6924
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 9232,
              "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": 7847.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6739.36
            },
            {
              "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": 5926.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5834.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 7847.2
            },
            {
              "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": 5123.76
            },
            {
              "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": 6739.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5834.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5834.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 7847.2
            },
            {
              "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": 7468.69
            },
            {
              "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": 9232,
              "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": 6924
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "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": 7570.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7570.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5834.62
            },
            {
              "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": 5834.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7468.69
            },
            {
              "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": 7570.24
            },
            {
              "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": 5834.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "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": 5123.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5077.6
            },
            {
              "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": 1433.71,
              "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": 7653.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 9232,
              "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": 5926.94
            },
            {
              "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": 5926.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6010.03
            },
            {
              "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": 5123.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5834.62
            },
            {
              "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": 1379.09,
              "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": 1365.43,
              "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": 5077.6
            },
            {
              "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": 9232,
              "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": 1393.3,
              "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": 7570.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5077.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 9232,
              "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": 5926.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5077.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6739.36
            },
            {
              "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": 1393.3,
              "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": 9232,
              "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": 1336.57,
              "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": 1365.43,
              "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": 9232,
              "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": 9232,
              "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": 9232,
              "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": 7847.2
            },
            {
              "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": 2021.81
            },
            {
              "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": 6010.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6739.36
            },
            {
              "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": 1379.09,
              "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": 8096.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "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": 2520.34
            },
            {
              "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": 1336.57,
              "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": 5077.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9232,
              "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": 6000.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5077.6
            },
            {
              "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": 1393.3,
              "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": 5926.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6010.03
            },
            {
              "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": 6010.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5926.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7653.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6739.36
            },
            {
              "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": 5077.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6924
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7847.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7653.33
            },
            {
              "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": 1379.09,
              "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": 5926.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5926.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7570.24
            },
            {
              "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": 7847.2
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hyperbaric Oxygen Full Body per 30min",
      "code_information": [
        {
          "code": "PX-41300001",
          "type": "CDM"
        },
        {
          "code": "G0277",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2017,
          "discounted_cash": 1311.05,
          "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": 1294.91
            },
            {
              "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": 121.11,
              "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": 2017,
              "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": 1714.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 1472.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1472.41
            },
            {
              "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": 1631.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1512.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 123.58,
              "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": 2017,
              "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": 1714.45
            },
            {
              "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": 1294.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 1313.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1714.45
            },
            {
              "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": 121.11,
              "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": 1274.74
            },
            {
              "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": 2017,
              "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": 1109.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1472.41
            },
            {
              "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": 1472.41
            },
            {
              "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": 1119.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1653.94
            },
            {
              "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": 122.32,
              "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": 1274.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1109.35
            },
            {
              "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": 122.32,
              "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": 121.11,
              "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": 1653.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 1313.07
            },
            {
              "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": 1653.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1653.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1672.09
            },
            {
              "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": 127.16,
              "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": 1714.45
            },
            {
              "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": 1274.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 441.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1109.35
            },
            {
              "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": 121.11,
              "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": 1768.91
            },
            {
              "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": 1313.07
            },
            {
              "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": 1768.91
            },
            {
              "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": 123.58,
              "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": 127.16,
              "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": 2017,
              "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": 2017,
              "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": 1714.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1294.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1653.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1631.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 2017,
              "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": 1774.96
            },
            {
              "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": 123.58,
              "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": 1672.09
            },
            {
              "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": 1311.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1714.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2017
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 1714.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1109.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1109.35
            },
            {
              "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": 122.32,
              "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": 1274.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1472.41
            },
            {
              "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": 1119.44
            },
            {
              "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": 1119.44
            },
            {
              "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": 1109.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 2017,
              "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": 1714.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1294.91
            },
            {
              "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": 127.16,
              "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": 1714.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1274.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 1672.09
            },
            {
              "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": 1313.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1653.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1714.45
            },
            {
              "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": 1653.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1294.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1294.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1653.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1512.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "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": 2017,
              "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": 2017,
              "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": 1512.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1274.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1714.45
            },
            {
              "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": 2017,
              "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": 2017,
              "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": 122.32,
              "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": 1714.45
            },
            {
              "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": 122.32,
              "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": 1714.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1294.91
            },
            {
              "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": 1294.91
            },
            {
              "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": 1294.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1313.07
            },
            {
              "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": 1294.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1109.35
            },
            {
              "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": 1274.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1714.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1274.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1119.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1294.91
            },
            {
              "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": 550.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1472.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1294.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2017,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Wrap Conforming Gauze Roll 3 in X 75 in Non Sterile",
      "code_information": [
        {
          "code": "PX-CH-KN2244",
          "type": "CDM"
        },
        {
          "code": "A6449",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.54,
          "discounted_cash": 0.35,
          "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": 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": 0.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.44
            },
            {
              "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": 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": 0.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.35
            },
            {
              "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": 0.54,
              "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": 0.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.35
            },
            {
              "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": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.54,
              "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": 0.35
            },
            {
              "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": 0.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.3
            },
            {
              "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": 0.54,
              "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": 0.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.54,
              "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": 0.54,
              "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": 0.54,
              "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": 0.35
            },
            {
              "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": 0.44
            },
            {
              "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": 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": 0.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.35
            },
            {
              "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": 0.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.54,
              "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": 0.54,
              "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": 0.48
            },
            {
              "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": 0.34
            },
            {
              "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": 0.54,
              "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": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.3
            },
            {
              "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": 0.46
            },
            {
              "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": 0.54,
              "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": 0.54,
              "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": 0.54,
              "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": 0.54,
              "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": 0.3
            },
            {
              "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": 0.54,
              "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": 0.54,
              "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": 0.35
            },
            {
              "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": 0.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.54,
              "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": 0.46
            },
            {
              "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": 0.54,
              "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": 0.45
            },
            {
              "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": 0.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.34
            },
            {
              "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": 0.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.54,
              "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": 0.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.39
            },
            {
              "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": 0.54,
              "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": 0.54,
              "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": 0.54,
              "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": 0.54,
              "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": 0.41
            },
            {
              "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": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.34
            },
            {
              "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": 0.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.3
            },
            {
              "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": 0.54,
              "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": 0.54,
              "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": 0.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.46
            },
            {
              "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": 0.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.54,
              "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": 0.54,
              "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": 0.3
            },
            {
              "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": 0.54,
              "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": 0.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.46
            },
            {
              "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": 0.44
            },
            {
              "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": 0.54,
              "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": 0.34
            },
            {
              "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": 0.35
            },
            {
              "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": 0.54,
              "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": 0.35
            },
            {
              "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": 0.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.35
            },
            {
              "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": 0.46
            }
          ]
        }
      ]
    },
    {
      "description": "Pt Manual Therapy 15 Min",
      "code_information": [
        {
          "code": "PX-42000023",
          "type": "CDM"
        },
        {
          "code": "97140",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 198,
          "discounted_cash": 128.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 127.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 160.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.9
            },
            {
              "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": 29.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 127.12
            },
            {
              "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": 198,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.36
            },
            {
              "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": 25.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.54
            },
            {
              "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": 25.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 127.12
            },
            {
              "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": 162.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 198,
              "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": 168.3
            },
            {
              "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": 164.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 164.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 164.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.54
            },
            {
              "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": 160.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 127.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 198,
              "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": 127.12
            },
            {
              "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": 168.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.9
            },
            {
              "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": 168.3
            },
            {
              "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": 109.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 168.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 198
            },
            {
              "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": 25.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 125.14
            },
            {
              "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": 25.88
            },
            {
              "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": 128.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 198,
              "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": 144.54
            },
            {
              "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": 198,
              "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": 108.9
            },
            {
              "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": 25.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.9
            },
            {
              "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": 109.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 108.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.54
            },
            {
              "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": 25.88
            },
            {
              "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": 108.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.54
            },
            {
              "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": 25.88
            },
            {
              "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": 162.36
            },
            {
              "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": 162.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 125.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 125.14
            },
            {
              "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": 174.24
            },
            {
              "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": 25.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 25.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 25.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 127.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 198,
              "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": 168.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168.3
            },
            {
              "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": 198,
              "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": 168.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 127.12
            },
            {
              "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": 27.17
            },
            {
              "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": 173.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168.3
            },
            {
              "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": 125.14
            },
            {
              "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": 198,
              "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": 128.7
            },
            {
              "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": 109.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 109.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 198,
              "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": 168.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 127.12
            },
            {
              "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": 128.9
            },
            {
              "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": 125.14
            },
            {
              "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": 173.65
            },
            {
              "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": 54.05
            },
            {
              "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": 25.88
            },
            {
              "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": 125.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 125.14
            },
            {
              "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": 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": 127.12
            },
            {
              "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": 127.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 108.9
            },
            {
              "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": 127.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 125.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 198,
              "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": 168.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.54
            },
            {
              "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": 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": 198,
              "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": 198,
              "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": 127.12
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrophilic Drsg Dermagran 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-DRSPD-21",
          "type": "CDM"
        },
        {
          "code": "A6231",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.19,
          "discounted_cash": 3.37,
          "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": 3.33
            },
            {
              "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": 4.2
            },
            {
              "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": 4.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.33
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 5.19,
              "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": 4.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 4.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.41
            },
            {
              "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": 5.19,
              "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": 5.19,
              "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": 4.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 3.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 3.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 2.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.85
            },
            {
              "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": 3.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 3.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.79
            },
            {
              "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": 3.37
            },
            {
              "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": 3.38
            },
            {
              "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": 4.55
            },
            {
              "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": 4.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.41
            },
            {
              "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": 5.19,
              "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": 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": 3.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 4.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 5.19,
              "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": 2.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.19,
              "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": 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": 1.42
            },
            {
              "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": 2.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 5.19,
              "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": 3.28
            },
            {
              "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": 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": 3.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 4.41
            },
            {
              "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": 5.19,
              "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": 3.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.41
            },
            {
              "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": 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": 3.33
            },
            {
              "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": 4.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 5.19,
              "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": 3.38
            },
            {
              "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": 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": 2.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 5.19,
              "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": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 5.19,
              "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": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.19,
              "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": 2.88
            },
            {
              "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": 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": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.33
            },
            {
              "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": 5.19,
              "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": 4.41
            },
            {
              "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": 3.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.41
            }
          ]
        }
      ]
    },
    {
      "description": "HC Repair Lip Vermilion Only",
      "code_information": [
        {
          "code": "PX-45000008",
          "type": "CDM"
        },
        {
          "code": "40650",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1277,
          "discounted_cash": 830.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "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": 1277,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 828.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 828.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.21
            },
            {
              "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": 939.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 957.75
            },
            {
              "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": 1119.93
            },
            {
              "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": 1123.76
            },
            {
              "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": 1277,
              "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": 934.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 938.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "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": 934.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "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": 938.6
            },
            {
              "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": 831.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "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": 938.6
            },
            {
              "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": 1119.93
            },
            {
              "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": 938.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1277,
              "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": 1058.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 828.77
            },
            {
              "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": 939.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 828.77
            },
            {
              "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": 801.96
            },
            {
              "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": 939.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 957.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.21
            },
            {
              "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": 830.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "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": 1277,
              "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": 348.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "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": 1277,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "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": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 934.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.33
            },
            {
              "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": 1047.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "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": 1047.14
            },
            {
              "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": 1085.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1058.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 957.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1033.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.33
            },
            {
              "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": 1047.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "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": 932.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 939.87
            },
            {
              "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": 939.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "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": 702.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 801.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.14
            },
            {
              "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": 801.96
            },
            {
              "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": 831.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.21
            },
            {
              "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": 1085.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1085.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1277
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.35
            },
            {
              "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": 934.76
            },
            {
              "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": 801.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1058.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.33
            },
            {
              "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": 1033.09
            }
          ]
        }
      ]
    },
    {
      "description": "HC Delayed Plcmnt Ext Prosthesis for Endovasc Rep Init Vessel W Img",
      "code_information": [
        {
          "code": "PX-36100901",
          "type": "CDM"
        },
        {
          "code": "34710",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18687,
          "discounted_cash": 12146.55,
          "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": 11997.05
            },
            {
              "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": 12165.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15883.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10277.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15883.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "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": 18687,
              "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": 18687,
              "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": 18687,
              "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": 12165.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14015.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10277.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15491.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11810.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11810.18
            },
            {
              "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": 15883.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11997.05
            },
            {
              "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": 15117.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15323.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15883.95
            },
            {
              "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": 11997.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13641.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13641.51
            },
            {
              "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": 12165.24
            },
            {
              "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": 15323.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11810.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "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": 18687,
              "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": 13641.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15883.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11997.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "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": 12165.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15323.34
            },
            {
              "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": 18687,
              "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": 18687,
              "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": 15883.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11997.05
            },
            {
              "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": 11997.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "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": 18687,
              "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": 18687,
              "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": 11810.18
            },
            {
              "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": 15491.52
            },
            {
              "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": 11997.05
            },
            {
              "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": 15323.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10277.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18687,
              "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": 15883.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "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": 15883.95
            },
            {
              "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": 5101.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11997.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10277.85
            },
            {
              "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": 11997.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15323.34
            },
            {
              "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": 16444.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13641.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15883.95
            },
            {
              "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": 18687,
              "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": 18687,
              "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": 16388.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15883.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15323.34
            },
            {
              "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": 18687,
              "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": 11810.18
            },
            {
              "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": 11810.18
            },
            {
              "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": 12146.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15491.52
            },
            {
              "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": 11810.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15117.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10277.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14015.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "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": 18687,
              "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": 15883.95
            },
            {
              "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": 15323.34
            },
            {
              "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": 11810.18
            },
            {
              "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": 16388.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "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": 10277.85
            },
            {
              "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": 18687,
              "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": 11997.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11997.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14015.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15883.95
            },
            {
              "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": 10277.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12165.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15323.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13641.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13641.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11997.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18687,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Perc Access & Closure Fem Art for Endgrft Del Uni W Img Add On",
      "code_information": [
        {
          "code": "PX-36100904",
          "type": "CDM"
        },
        {
          "code": "34713",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17429,
          "discounted_cash": 11328.85,
          "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": 11189.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11189.42
            },
            {
              "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": 14814.65
            },
            {
              "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": 17429,
              "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": 15337.52
            },
            {
              "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": 17429,
              "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": 11189.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 11189.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11015.13
            },
            {
              "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": 15285.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9585.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 11328.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11189.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14291.78
            },
            {
              "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": 14291.78
            },
            {
              "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": 14291.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14814.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9585.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12723.17
            },
            {
              "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": 14291.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13071.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 17429,
              "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": 14814.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12723.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14100.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11346.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14448.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13071.75
            },
            {
              "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": 11346.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14291.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11015.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 17429,
              "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": 17429,
              "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": 17429,
              "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": 14814.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14814.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11189.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14291.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12723.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 17429,
              "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": 9585.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12723.17
            },
            {
              "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": 17429,
              "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": 17429,
              "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": 14814.65
            },
            {
              "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": 11346.28
            },
            {
              "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": 11189.42
            },
            {
              "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": 14814.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 14814.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11189.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9585.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14448.64
            },
            {
              "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": 11015.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11015.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12723.17
            },
            {
              "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": 14448.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11346.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14814.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11015.13
            },
            {
              "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": 17429,
              "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": 11015.13
            },
            {
              "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": 15285.23
            },
            {
              "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": 14100.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 17429,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11189.42
            },
            {
              "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": 17429,
              "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": 17429,
              "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": 11189.42
            },
            {
              "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": 11015.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "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": 14814.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11346.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14291.78
            },
            {
              "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": 4758.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14814.65
            },
            {
              "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": 11015.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9585.95
            },
            {
              "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": 12723.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11189.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11189.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14291.78
            },
            {
              "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": 9585.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9585.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14814.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13071.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 17429,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Endoven Ablat Incompetent Ext Vein W Img Addl Vein",
      "code_information": [
        {
          "code": "PX-36100908",
          "type": "CDM"
        },
        {
          "code": "36483",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3761,
          "discounted_cash": 2444.65,
          "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": 2414.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2068.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2376.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3117.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2448.41
            },
            {
              "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": 2414.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3761,
              "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": 3196.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2068.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2068.55
            },
            {
              "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": 3298.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2414.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 2448.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 2068.55
            },
            {
              "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": 3196.85
            },
            {
              "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": 3042.65
            },
            {
              "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": 2448.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3761,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2414.56
            },
            {
              "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": 2376.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3196.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2376.95
            },
            {
              "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": 3761,
              "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": 2414.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2414.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3761,
              "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": 2444.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3196.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2745.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2068.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2745.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2745.53
            },
            {
              "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": 3117.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3084.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2068.55
            },
            {
              "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": 2376.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 2414.56
            },
            {
              "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": 3298.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2376.95
            },
            {
              "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": 3761,
              "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": 2414.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2448.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2820.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2414.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2820.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2376.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3196.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3196.85
            },
            {
              "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": 3761,
              "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": 2414.56
            },
            {
              "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": 3084.02
            },
            {
              "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": 1026.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3084.02
            },
            {
              "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": 3309.68
            },
            {
              "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": 2414.56
            },
            {
              "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": 2068.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3196.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3196.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3761,
              "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": 2745.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2376.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3196.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3084.02
            },
            {
              "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": 3084.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3084.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2820.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 3042.65
            },
            {
              "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": 3084.02
            },
            {
              "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": 3761,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3761,
              "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": 2745.53
            },
            {
              "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": 3196.85
            },
            {
              "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": 3761,
              "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": 3196.85
            },
            {
              "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": 2376.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2745.53
            },
            {
              "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": 2414.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3084.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3117.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3761,
              "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": 3761,
              "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": 3196.85
            },
            {
              "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": 2448.41
            }
          ]
        }
      ]
    },
    {
      "description": "HC ER Level V",
      "code_information": [
        {
          "code": "PX-45000038",
          "type": "CDM"
        },
        {
          "code": "99285",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3970,
          "discounted_cash": 2580.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2906.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3291.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2977.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.8,
              "estimated_amount": 3287.16
            },
            {
              "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": 3374.5
            },
            {
              "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": 2921.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3255.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "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": 3374.5
            },
            {
              "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": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "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": 2584.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "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": 588.63,
              "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": 3970,
              "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": 560.6,
              "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": 3970,
              "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": 3255.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "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": 869.43
            },
            {
              "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": 2906.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3255.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3211.73
            },
            {
              "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": 3211.73
            },
            {
              "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": 3481.69
            },
            {
              "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": 2921.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2584.47
            },
            {
              "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": 3255.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "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": 572.04,
              "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": 572.04,
              "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": 3255.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3255.4
            },
            {
              "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": 2921.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "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": 3255.4
            },
            {
              "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": 1083.81
            },
            {
              "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": 560.6,
              "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": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2898.1
            },
            {
              "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": 572.04,
              "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": 566.21,
              "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": 3493.6
            },
            {
              "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": 560.6,
              "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": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3255.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 2917.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "case rate",
              "standard_charge_dollar": 260,
              "estimated_amount": 260
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2906.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2584.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "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": 2921.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "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": 2906.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2977.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2183.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2906.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.8,
              "estimated_amount": 3287.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "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": 2898.1
            },
            {
              "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": 560.6,
              "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": 2898.1
            },
            {
              "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": 566.21,
              "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": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2921.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2584.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2906.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2183.5
            },
            {
              "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": 588.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2183.5
            },
            {
              "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": 566.21,
              "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": 3970
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2584.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2898.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2898.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "case rate",
              "standard_charge_dollar": 260,
              "estimated_amount": 260
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2906.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2183.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3291.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "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": 588.63,
              "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": 2183.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.8,
              "estimated_amount": 3287.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3374.5
            },
            {
              "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": 560.6,
              "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": 73.2,
              "estimated_amount": 2906.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2183.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2898.1
            },
            {
              "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": 2917.95
            },
            {
              "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": 2183.5
            },
            {
              "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": 2580.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2977.5
            },
            {
              "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": 2917.95
            },
            {
              "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": 560.6,
              "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": 3970,
              "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": 3481.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.8,
              "estimated_amount": 3287.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 3148.21
            },
            {
              "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": 2917.95
            },
            {
              "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": 566.21,
              "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": 3291.13
            },
            {
              "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": 566.21,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 260,
          "maximum": 260
        }
      ]
    },
    {
      "description": "HC Xr Chest 3 Views",
      "code_information": [
        {
          "code": "PX-32400009",
          "type": "CDM"
        },
        {
          "code": "71047",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 386,
          "discounted_cash": 250.9,
          "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": 247.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 386,
              "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": 214.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 212.3
            },
            {
              "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": 247.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 312.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 243.95
            },
            {
              "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": 339.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 328.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 289.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 281.78
            },
            {
              "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": 247.81
            },
            {
              "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": 247.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 328.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 212.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 289.5
            },
            {
              "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": 243.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 212.3
            },
            {
              "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": 214.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 247.81
            },
            {
              "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": 328.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 386,
              "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": 250.9
            },
            {
              "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": 80.1,
              "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": 251.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 251.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 316.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 328.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 281.78
            },
            {
              "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": 80.1,
              "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": 312.27
            },
            {
              "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": 83.28,
              "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": 328.1
            },
            {
              "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": 80.1,
              "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": 386,
              "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": 247.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 316.52
            },
            {
              "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": 79.31,
              "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": 319.99
            },
            {
              "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": 212.3
            },
            {
              "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": 247.81
            },
            {
              "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": 338.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 281.78
            },
            {
              "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": 83.28,
              "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": 251.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 212.3
            },
            {
              "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": 79.31,
              "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": 386,
              "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": 386,
              "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": 281.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 316.52
            },
            {
              "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": 105.38
            },
            {
              "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": 79.31,
              "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": 243.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 386,
              "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": 328.1
            },
            {
              "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": 386,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.28,
              "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": 386
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 80.93,
              "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": 80.93,
              "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": 247.81
            },
            {
              "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": 316.52
            },
            {
              "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": 386,
              "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": 243.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 281.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 386,
              "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": 386,
              "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": 247.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 212.3
            },
            {
              "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": 80.1,
              "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": 328.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 247.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 328.1
            },
            {
              "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": 214.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 243.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 243.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 328.1
            },
            {
              "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": 251.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 281.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 214.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 316.52
            },
            {
              "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": 316.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 319.99
            },
            {
              "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": 243.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 289.5
            },
            {
              "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": 247.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 247.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 243.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 328.1
            },
            {
              "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": 338.52
            },
            {
              "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": 251.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 319.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 316.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 328.1
            },
            {
              "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": 316.52
            },
            {
              "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": 80.1,
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 386,
              "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": 386,
              "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": 80.93,
              "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": 328.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 212.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 328.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tx Fx Dislocation Open",
      "code_information": [
        {
          "code": "PX-45000048",
          "type": "CDM"
        },
        {
          "code": "45000048",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1375,
          "discounted_cash": 893.75,
          "payers_information": [
            {
              "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": 1012
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "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": 1210
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 895.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 756.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1127.5
            },
            {
              "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": 375.38
            },
            {
              "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": 1010.63
            },
            {
              "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": 1127.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1127.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "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": 1012
            },
            {
              "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": 1012
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "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": 893.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 895.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1003.75
            },
            {
              "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": 1168.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1127.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1031.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 756.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1006.5
            },
            {
              "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": 1003.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1006.5
            },
            {
              "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": 1006.5
            },
            {
              "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": 1205.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "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": 1205.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "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": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1003.75
            },
            {
              "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": 1375,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1003.75
            },
            {
              "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": 1127.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1127.5
            },
            {
              "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": 1012
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1375,
              "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": 756.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 892.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1031.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1112.38
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1003.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 892.38
            },
            {
              "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": 756.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1139.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1375,
              "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": 756.25
            },
            {
              "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": 1006.5
            },
            {
              "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": 1375,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1010.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "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": 1168.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "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": 1010.63
            },
            {
              "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": 1006.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "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": 1375,
              "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": 863.5
            },
            {
              "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": 863.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 895.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1127.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 892.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 892.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1003.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 895.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 756.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1375
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1012
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1127.5
            },
            {
              "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": 863.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1168.75
            },
            {
              "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": 1112.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1139.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 863.5
            },
            {
              "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": 1010.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 756.25
            },
            {
              "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": 895.13
            },
            {
              "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": 1139.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1031.25
            }
          ]
        }
      ]
    },
    {
      "description": "Human Platelet Antigen 15 Genotyping Sendout",
      "code_information": [
        {
          "code": "PX-30101276",
          "type": "CDM"
        },
        {
          "code": "81112",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 173,
          "discounted_cash": 112.45,
          "payers_information": [
            {
              "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": 108.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 108.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 141.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 95.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 126.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 129.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 126.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 108.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 108.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 95.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 126.29
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.85,
              "estimated_amount": 104.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 173,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "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": 108.13
            },
            {
              "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": 62.5,
              "estimated_amount": 108.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 95.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 154.21,
              "estimated_amount": 154.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 126.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 108.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 108.13
            },
            {
              "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": 141.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 173,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 141.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.85,
              "estimated_amount": 104.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 141.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 108.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "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": 86.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 173,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": 173,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.85,
              "estimated_amount": 104.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 95.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 128.33,
              "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": 141.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 173,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 128.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "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": 112.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 173,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 154.21,
              "estimated_amount": 154.21
            },
            {
              "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": 152.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 129.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 95.15
            },
            {
              "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": 126.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 126.29
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "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": 95.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "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": 86.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "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": 147.05
            },
            {
              "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": 108.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 147.05
            },
            {
              "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": 173,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 141.86
            },
            {
              "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": 147.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 122.22,
              "estimated_amount": 122.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 123.44,
              "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": 147.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 129.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 122.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 128.33,
              "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": 25,
              "estimated_amount": 43.25
            },
            {
              "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": 108.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 104.85,
              "estimated_amount": 104.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 95.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 458.33,
              "estimated_amount": 458.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 108.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 86.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 141.86
            },
            {
              "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": 141.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 173,
              "additional_payer_notes": "Reference Lab"
            }
          ],
          "minimum": 104.85,
          "maximum": 458.33
        }
      ]
    },
    {
      "description": "Hba1/Hba2, Gene Analysis; Duplication/Deletion Variants Sendout",
      "code_information": [
        {
          "code": "PX-30101290",
          "type": "CDM"
        },
        {
          "code": "81269",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 877,
          "discounted_cash": 570.05,
          "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": 563.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "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": 727.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 563.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 657.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 570.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 719.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 202.4,
              "estimated_amount": 202.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 482.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 204.42,
              "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": 640.21
            },
            {
              "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": 769.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 877,
              "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": 554.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 570.05
            },
            {
              "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": 877,
              "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": 745.45
            },
            {
              "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": 563.03
            },
            {
              "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": 719.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 202.4,
              "estimated_amount": 202.4
            },
            {
              "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": 745.45
            },
            {
              "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": 719.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 719.14
            },
            {
              "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": 554.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 563.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 482.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 563.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 554.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 482.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 202.4,
              "estimated_amount": 202.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "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": 486.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 719.14
            },
            {
              "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": 482.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 482.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 640.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 202.4,
              "estimated_amount": 202.4
            },
            {
              "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": 486.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "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": 563.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 563.03
            },
            {
              "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": 570.93
            },
            {
              "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": 719.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 554.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 719.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 563.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 570.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 640.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 204.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 204.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 204.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 212.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 563.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 657.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 482.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 640.21
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 212.52,
              "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": 554.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 563.03
            },
            {
              "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": 554.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "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": 709.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 727.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "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": 745.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 657.75
            },
            {
              "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": 563.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 570.93
            },
            {
              "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": 239.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 202.4,
              "estimated_amount": 202.4
            },
            {
              "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": 877,
              "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": 640.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 554.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 719.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 640.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 482.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 202.4,
              "estimated_amount": 202.4
            },
            {
              "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": 771.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 554.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 202.4,
              "estimated_amount": 202.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 212.52,
              "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": 745.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 486.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 877,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 877,
              "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": 486.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 709.49
            },
            {
              "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": 877,
              "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": 563.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 759,
              "estimated_amount": 759
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 769.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 877
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 202.4,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 204.42,
              "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": 570.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 745.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 727.03
            }
          ],
          "minimum": 202.4,
          "maximum": 759
        }
      ]
    },
    {
      "description": "2 Pc Pouch 4 in New Image Lock & Roll Closure",
      "code_information": [
        {
          "code": "PX-CH-HO18006",
          "type": "CDM"
        },
        {
          "code": "A5063",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.04,
          "discounted_cash": 1.33,
          "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": 1.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 1.67
            },
            {
              "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": 1.69
            },
            {
              "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": 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": 1.31
            },
            {
              "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": 2.04,
              "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": 2.04,
              "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": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 2.04,
              "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": 1.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.04
            },
            {
              "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": 1.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 1.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.73
            },
            {
              "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": 2.04,
              "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": 2.04,
              "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": 1.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 1.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.73
            },
            {
              "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": 1.65
            },
            {
              "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": 0.56
            },
            {
              "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": 2.04,
              "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": 1.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 2.04,
              "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": 1.31
            },
            {
              "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": 1.31
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.73
            },
            {
              "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": 2.04,
              "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": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.33
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 2.04,
              "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": 1.13
            },
            {
              "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": 2.04,
              "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": 1.29
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 1.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 1.69
            },
            {
              "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": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.04,
              "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": 2.04,
              "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": 2.04,
              "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": 2.04,
              "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": 2.04,
              "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": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 1.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.49
            },
            {
              "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": 2.04,
              "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": 1.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.31
            },
            {
              "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": 1.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.12
            },
            {
              "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": 2.04,
              "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": 2.04,
              "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": 2.04,
              "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": 2.04,
              "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": 1.53
            },
            {
              "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": 1.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.12
            },
            {
              "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": 2.04,
              "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": 2.04,
              "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": 1.67
            },
            {
              "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": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.12
            },
            {
              "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": 2.04,
              "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": 2.04,
              "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": 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": 1.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.12
            },
            {
              "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": 1.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.73
            },
            {
              "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": 1.73
            },
            {
              "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": 2.04,
              "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": 1.31
            },
            {
              "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": 2.04,
              "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": 2.04,
              "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": 2.04,
              "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": 1.31
            },
            {
              "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": 1.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.04,
              "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": 1.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.67
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Sponge Sterile Versalon 4 in X 4 in 4-Ply",
      "code_information": [
        {
          "code": "PX-CH-KN8044",
          "type": "CDM"
        },
        {
          "code": "A6402",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.09,
          "discounted_cash": 0.06,
          "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": 0.06
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.06
            },
            {
              "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": "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": "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": "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": "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 OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.06
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.07
            },
            {
              "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": "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 OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "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": 0.09,
              "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": 0.06
            },
            {
              "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": "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC 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": "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": "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": "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": "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": "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": "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": "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": "GENERAL AMERICAN LIFE OHCP [535220]",
              "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": "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "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": "BUCKEYE COMMUNITY 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": "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.06
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "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": "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": "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": "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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "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": 0.09,
              "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": 0.06
            },
            {
              "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": 0.09,
              "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": 0.06
            },
            {
              "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": "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": "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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "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": 0.07
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.07
            },
            {
              "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": 0.09,
              "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": 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": "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": "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/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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "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": 0.06
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "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": 0.09,
              "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": 0.05
            },
            {
              "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 [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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 0.08
            },
            {
              "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN 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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "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": 0.06
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "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": "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": "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": "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": "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": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "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": 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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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 [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 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"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Audio Pure Tone Air Screen",
      "code_information": [
        {
          "code": "PX-47100002",
          "type": "CDM"
        },
        {
          "code": "92551",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 122,
          "discounted_cash": 79.3,
          "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": 78.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 103.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122,
              "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": 122,
              "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": 77.1
            },
            {
              "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": 79.42
            },
            {
              "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": 122,
              "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": 78.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 67.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 98.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 101.14
            },
            {
              "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": 77.1
            },
            {
              "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": 100.04
            },
            {
              "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": 106.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 103.7
            },
            {
              "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": 122,
              "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": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 100.04
            },
            {
              "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": 122,
              "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": 89.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 67.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 101.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 67.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "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": 106.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 100.04
            },
            {
              "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": 78.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 122,
              "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": 78.32
            },
            {
              "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": 67.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 122
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "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": 79.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 89.06
            },
            {
              "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": 77.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 78.32
            },
            {
              "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": 100.04
            },
            {
              "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": 33.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 101.14
            },
            {
              "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": 77.1
            },
            {
              "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": 79.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "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": 78.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 67.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.5
            },
            {
              "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": 107.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "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": 122,
              "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": 98.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "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": 100.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 103.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "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": 103.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Transtelephonic Pacer Eval",
      "code_information": [
        {
          "code": "PX-48000018",
          "type": "CDM"
        },
        {
          "code": "93293",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 175,
          "discounted_cash": 113.75,
          "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": 112.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 97.13
            },
            {
              "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": 112.35
            },
            {
              "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": 175,
              "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": 127.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 148.75
            },
            {
              "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": 153.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "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": 113.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 175,
              "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": 96.25
            },
            {
              "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": 127.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "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": 96.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "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": 110.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 131.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "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": 112.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "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": 153.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 33.58,
              "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": 148.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 175,
              "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": 148.75
            },
            {
              "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": 112.35
            },
            {
              "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": 143.5
            },
            {
              "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": 145.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "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": 33.24,
              "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": 175,
              "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": 154
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 113.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "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": 32.91,
              "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": 97.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 145.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 175
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "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": 33.24,
              "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": 148.75
            },
            {
              "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": 110.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 113.93
            },
            {
              "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": 34.56,
              "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": 32.91,
              "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": 148.75
            },
            {
              "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": 33.58,
              "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": 112.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 127.75
            },
            {
              "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": 32.91,
              "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": 175,
              "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": 175,
              "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": 175,
              "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": 175,
              "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": 141.58
            },
            {
              "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": 113.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "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": 34.56,
              "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": 34.56,
              "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": 113.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 113.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "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": 47.78
            },
            {
              "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": 33.24,
              "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": 175,
              "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": 175,
              "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": 112.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 96.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 148.75
            },
            {
              "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": 175,
              "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": 141.58
            },
            {
              "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": 143.5
            },
            {
              "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": 97.13
            },
            {
              "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": 148.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "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": 175,
              "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": 33.58,
              "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": 175,
              "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": 33.24,
              "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": 97.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "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": 175,
              "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": 175,
              "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": 131.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 131.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 112.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 143.5
            },
            {
              "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": 33.24,
              "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": 148.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 110.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 175,
              "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": 110.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 148.75
            },
            {
              "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": 112.35
            },
            {
              "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": 143.5
            },
            {
              "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": 32.91,
              "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": 148.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Unlisted Cardiovascular Procedure",
      "code_information": [
        {
          "code": "PX-48000052",
          "type": "CDM"
        },
        {
          "code": "93799",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5040,
          "discounted_cash": 3276,
          "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": 3235.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3235.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 3679.2
            },
            {
              "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": 137.7,
              "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": 5040,
              "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": 5040,
              "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": 4284
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4420.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 3235.68
            },
            {
              "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": 3281.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2772
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5040,
              "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": 3185.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3185.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3185.28
            },
            {
              "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": 139.11,
              "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": 3235.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3281.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 5040,
              "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": 3679.2
            },
            {
              "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": 3185.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3679.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5040
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5040,
              "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": 3679.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2797.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3235.68
            },
            {
              "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": 3281.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3780
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1375.92
            },
            {
              "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": 137.7,
              "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": 4077.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4132.8
            },
            {
              "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": 3276
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 139.11,
              "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": 2772
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4132.8
            },
            {
              "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": 3679.2
            },
            {
              "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": 136.33,
              "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": 143.15,
              "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": 4284
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4178.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3235.68
            },
            {
              "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": 4077.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3235.68
            },
            {
              "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": 136.33,
              "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": 3185.28
            },
            {
              "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": 3185.28
            },
            {
              "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": 4284
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "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": 1103.76
            },
            {
              "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": 137.7,
              "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": 3235.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4132.8
            },
            {
              "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": 4132.8
            },
            {
              "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": 137.7,
              "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": 5040,
              "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": 2772
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.15,
              "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": 3235.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3281.04
            },
            {
              "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": 4132.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4132.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 5040,
              "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": 4435.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4178.16
            },
            {
              "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": 5040,
              "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": 3235.68
            },
            {
              "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": 2797.2
            },
            {
              "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": 2797.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3679.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2772
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 4178.16
            },
            {
              "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": 2772
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4132.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 5040,
              "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": 137.7,
              "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": 143.15,
              "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": 2772
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3780
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3185.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2772
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "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": 5040,
              "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": 5040,
              "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": 5040,
              "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": 4132.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5040,
              "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": 5040,
              "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": 3281.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3780
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2797.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 139.11,
              "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": 4420.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3185.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4284
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3235.68
            },
            {
              "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": 136.33,
              "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": 5040,
              "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": 136.33,
              "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": 3235.68
            }
          ]
        }
      ]
    },
    {
      "description": "HC Atherectomy Sgl Maj Cor Art or Branch",
      "code_information": [
        {
          "code": "PX-48100003",
          "type": "CDM"
        },
        {
          "code": "92924",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18072,
          "discounted_cash": 11746.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11602.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11764.87
            },
            {
              "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": 4933.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13192.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 18072
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11421.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11764.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 18072
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14819.04
            },
            {
              "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": 9601.65,
              "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": 9601.65,
              "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": 18072,
              "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": 11602.22
            },
            {
              "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": 10081.73,
              "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": 15361.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9939.6
            },
            {
              "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": 10081.73,
              "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": 11421.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15361.2
            },
            {
              "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": 11421.5
            },
            {
              "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": 15849.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 9797.6,
              "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": 15361.2
            },
            {
              "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": 11602.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11602.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14981.69
            },
            {
              "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": 11602.22
            },
            {
              "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": 11764.87
            },
            {
              "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": 9797.6,
              "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": 15361.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11764.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14819.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 15903.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 18072
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9939.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9939.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9939.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9939.6
            },
            {
              "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": 9697.66,
              "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": 15361.2
            },
            {
              "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": 10081.73,
              "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": 9697.66,
              "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": 11602.22
            },
            {
              "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": 14819.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11602.22
            },
            {
              "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": 11602.22
            },
            {
              "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": 15849.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15361.2
            },
            {
              "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": 18072,
              "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": 15361.2
            },
            {
              "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": 11602.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 18072
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13554
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11421.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13192.56
            },
            {
              "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": 9601.65,
              "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": 15361.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11602.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14620.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 18072
            },
            {
              "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": 3957.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15361.2
            },
            {
              "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": 18072,
              "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": 14981.69
            },
            {
              "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": 9697.66,
              "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": 18072,
              "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": 11421.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 9939.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15361.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15361.2
            },
            {
              "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": 11764.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14819.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 18072,
              "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": 15361.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13554
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13554
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 18072,
              "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": 13192.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 14981.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15361.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11421.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 18072,
              "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": 14819.04
            },
            {
              "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": 13192.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13192.56
            },
            {
              "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": 9697.66,
              "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": 18072,
              "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": 9601.65,
              "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": 11602.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14819.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 13192.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15361.2
            },
            {
              "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": 9697.66,
              "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": 14819.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 18072,
              "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": 18072,
              "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": 18072,
              "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": 9939.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11602.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18072,
              "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": 11746.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11421.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11421.5
            },
            {
              "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": 14620.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14819.04
            },
            {
              "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": 9797.6,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Coronary Angiogrphy W Byp Grfts and Rhc",
      "code_information": [
        {
          "code": "PX-48100023",
          "type": "CDM"
        },
        {
          "code": "93457",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15984,
          "discounted_cash": 10389.6,
          "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": 10261.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12931.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13106.88
            },
            {
              "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": 4363.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 15984,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 15122
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11668.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10261.73
            },
            {
              "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": 2986.23,
              "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": 10101.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15984,
              "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": 13586.4
            },
            {
              "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": 8791.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10101.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 13586.4
            },
            {
              "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": 10261.73
            },
            {
              "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": 2872.46,
              "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": 13586.4
            },
            {
              "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": 12931.06
            },
            {
              "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": 14017.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10101.89
            },
            {
              "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": 2872.46,
              "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": 2844.02,
              "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": 11988
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10101.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10101.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 10405.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13106.88
            },
            {
              "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": 2844.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 15122
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11668.32
            },
            {
              "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": 2986.23,
              "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": 2844.02,
              "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": 14017.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 10261.73
            },
            {
              "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": 10101.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 15984,
              "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": 13586.4
            },
            {
              "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": 14065.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11988
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10405.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13106.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 15984,
              "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": 2902.07,
              "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": 13250.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8791.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11668.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13586.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 13586.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13106.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10405.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13250.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11988
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13586.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8791.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10261.73
            },
            {
              "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": 13106.88
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2986.23,
              "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": 10405.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13586.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8791.2
            },
            {
              "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": 15984,
              "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": 15984,
              "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": 2872.46,
              "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": 15984,
              "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": 11668.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10261.73
            },
            {
              "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": 13106.88
            },
            {
              "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": 2902.07,
              "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": 15984,
              "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": 10389.6
            },
            {
              "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": 15984,
              "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": 10405.58
            },
            {
              "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": 2902.07,
              "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": 3500.5
            },
            {
              "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": 11668.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 15122
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13106.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13586.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11668.32
            },
            {
              "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": 13586.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13586.4
            },
            {
              "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": 2872.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 15122
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15984,
              "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": 13586.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10261.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 15122
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10101.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 2872.46,
              "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": 10261.73
            },
            {
              "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": 10261.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13106.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 15984,
              "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": 8791.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8791.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10261.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13250.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13586.4
            },
            {
              "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": 2844.02,
              "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": 8791.2
            },
            {
              "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": 10261.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10101.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15984,
              "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": 13586.4
            },
            {
              "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": 15984,
              "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": 10261.73
            }
          ]
        }
      ]
    },
    {
      "description": "HC Revasc Occ During Mi De Stent Sgl",
      "code_information": [
        {
          "code": "PX-48100041",
          "type": "CDM"
        },
        {
          "code": "C9606",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20699,
          "discounted_cash": 13454.35,
          "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": 13288.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11384.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13081.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17594.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20699,
              "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": 17594.15
            },
            {
              "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": 15110.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15110.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13081.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13288.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 13475.05
            },
            {
              "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": 13081.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17159.47
            },
            {
              "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": 11384.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11384.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 20699
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 17594.15
            },
            {
              "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": 13454.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16973.18
            },
            {
              "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": 13081.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 20699
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15110.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17594.15
            },
            {
              "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": 20699,
              "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": 20699,
              "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": 20699,
              "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": 20699,
              "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": 17594.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 20699,
              "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": 16973.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15524.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 17594.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16973.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 20699
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 20699
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11384.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 13288.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13475.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17594.15
            },
            {
              "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": 13288.76
            },
            {
              "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": 17159.47
            },
            {
              "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": 17594.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13288.76
            },
            {
              "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": 13288.76
            },
            {
              "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": 16973.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15524.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15110.27
            },
            {
              "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": 13288.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 20699,
              "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": 17594.15
            },
            {
              "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": 16973.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13081.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17594.15
            },
            {
              "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": 20699,
              "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": 13288.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 20699,
              "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": 20699,
              "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": 16973.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16745.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 20699
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 13288.76
            },
            {
              "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": 16745.49
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15524.25
            },
            {
              "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": 20699,
              "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": 13081.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 13081.77
            },
            {
              "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": 18153.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11384.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 15110.27
            },
            {
              "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": 4533.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16973.18
            },
            {
              "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": 5650.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17159.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11384.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15110.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11384.45
            },
            {
              "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": 17594.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17594.15
            },
            {
              "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": 18215.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13288.76
            },
            {
              "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": 13475.05
            },
            {
              "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": 13475.05
            },
            {
              "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": 13288.76
            },
            {
              "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": 13081.77
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17594.15
            },
            {
              "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": 18153.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20699,
              "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": 13288.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13475.05
            },
            {
              "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": 16973.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17594.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Lumbar Spine W WO Contrast",
      "code_information": [
        {
          "code": "PX-61200009",
          "type": "CDM"
        },
        {
          "code": "72158",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2465,
          "discounted_cash": 1602.25,
          "payers_information": [
            {
              "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": 1814.24
            },
            {
              "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": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 2465,
              "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": 2465,
              "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": 1848.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1355.75
            },
            {
              "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": 1814.24
            },
            {
              "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": 1604.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1804.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 2169.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1799.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2095.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1848.75
            },
            {
              "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": 1814.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2021.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 339.01,
              "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": 2095.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2095.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1848.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 2095.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2465,
              "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": 2095.25
            },
            {
              "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": 2043.49
            },
            {
              "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": 335.65,
              "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": 2021.3
            },
            {
              "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": 352.43,
              "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": 1804.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2465
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2465,
              "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": 73.2,
              "estimated_amount": 1804.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "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": 1994.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 335.65,
              "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": 2465,
              "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": 2095.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1811.78
            },
            {
              "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": 1811.78
            },
            {
              "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": 2161.81
            },
            {
              "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": 335.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2021.3
            },
            {
              "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": 2465,
              "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": 2465,
              "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": 2021.3
            },
            {
              "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": 2021.3
            },
            {
              "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": 1811.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 2465,
              "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": 1355.75
            },
            {
              "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": 1799.45
            },
            {
              "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": 339.01,
              "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": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2095.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1355.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1799.45
            },
            {
              "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": 2095.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 2465,
              "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": 1604.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2021.3
            },
            {
              "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": 1804.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 539.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1799.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 342.5,
              "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": 2043.49
            },
            {
              "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": 2021.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1799.45
            },
            {
              "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": 352.43,
              "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": 2465,
              "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": 73.5,
              "estimated_amount": 1811.78
            },
            {
              "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": 1814.24
            },
            {
              "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": 672.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1804.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 342.5,
              "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": 2095.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1355.75
            },
            {
              "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": 339.01,
              "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": 2161.81
            },
            {
              "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": 2465,
              "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": 1604.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1604.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1604.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2095.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1799.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1804.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2465,
              "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": 2095.25
            },
            {
              "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": 339.01,
              "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": 352.43,
              "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": 1602.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1804.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1355.75
            },
            {
              "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": 342.5,
              "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": 2021.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2095.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2095.25
            },
            {
              "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": 1804.38
            },
            {
              "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": 335.65,
              "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": 1355.75
            },
            {
              "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": 339.01,
              "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": 2043.49
            },
            {
              "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": 1355.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "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": 2095.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1814.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1994.19
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Pelvis W Contrast",
      "code_information": [
        {
          "code": "PX-61400005",
          "type": "CDM"
        },
        {
          "code": "72196",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2150,
          "discounted_cash": 1397.5,
          "payers_information": [
            {
              "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": 1582.4
            },
            {
              "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": 335.65,
              "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": 1397.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1573.8
            },
            {
              "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": 1399.65
            },
            {
              "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": 352.43,
              "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": 1827.5
            },
            {
              "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": 1763
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1763
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1573.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 1182.5
            },
            {
              "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": 335.65,
              "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": 2150,
              "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": 73.5,
              "estimated_amount": 1580.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1573.8
            },
            {
              "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": 586.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1582.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1399.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 2150,
              "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": 1782.35
            },
            {
              "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": 1827.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1569.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 1182.5
            },
            {
              "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": 1827.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1582.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1612.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1182.5
            },
            {
              "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": 1569.5
            },
            {
              "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": 339.01,
              "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": 1782.35
            },
            {
              "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": 2150,
              "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": 339.01,
              "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": 73.6,
              "estimated_amount": 1582.4
            },
            {
              "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": 1582.4
            },
            {
              "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": 1763
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1612.5
            },
            {
              "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": 1885.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1182.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1827.5
            },
            {
              "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": 2150,
              "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": 342.5,
              "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": 1569.5
            },
            {
              "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": 1582.4
            },
            {
              "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": 1582.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1399.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1182.5
            },
            {
              "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": 339.01,
              "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": 335.65,
              "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": 1827.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1782.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1569.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1582.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1399.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1763
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 1827.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1827.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 73.5,
              "estimated_amount": 1580.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1827.5
            },
            {
              "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": 2150,
              "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": 2150,
              "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": 2150,
              "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": 1827.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1582.4
            },
            {
              "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": 1580.25
            },
            {
              "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": 1399.65
            },
            {
              "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": 1573.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1573.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1582.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1763
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1182.5
            },
            {
              "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": 339.01,
              "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": 342.5,
              "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": 73.2,
              "estimated_amount": 1573.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1763
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 352.43,
              "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": 1612.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 2150,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 470.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1763
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 2150,
              "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": 1827.5
            },
            {
              "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": 1885.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 335.65,
              "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": 1827.5
            },
            {
              "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": 1182.5
            },
            {
              "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": 352.43,
              "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": 2150,
              "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": 2150,
              "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": 342.5,
              "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": 2150
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1827.5
            },
            {
              "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": 1739.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1763
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1573.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 339.01,
              "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": 1827.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1827.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1580.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2150,
              "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": 1892
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1582.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1739.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1569.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1569.5
            },
            {
              "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": 2150,
              "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": 73.2,
              "estimated_amount": 1573.8
            },
            {
              "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": 73.6,
              "estimated_amount": 1582.4
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Pelvis W WO Contrast",
      "code_information": [
        {
          "code": "PX-61400006",
          "type": "CDM"
        },
        {
          "code": "72197",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2530,
          "discounted_cash": 1644.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1647.03
            },
            {
              "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": 690.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1846.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "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": 352.43,
              "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": 73.2,
              "estimated_amount": 1851.96
            },
            {
              "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": 1862.08
            },
            {
              "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": 1647.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1851.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1846.9
            },
            {
              "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": 352.43,
              "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": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "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": 1647.03
            },
            {
              "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": 342.5,
              "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": 2074.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1897.5
            },
            {
              "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": 2530,
              "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": 1391.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1846.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1391.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1391.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2097.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 2530
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1851.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1391.5
            },
            {
              "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": 2074.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1647.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1851.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1851.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 2097.37
            },
            {
              "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": 1391.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 2046.77
            },
            {
              "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": 2530,
              "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": 2150.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2074.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1897.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2074.6
            },
            {
              "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": 339.01,
              "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": 339.01,
              "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": 2530,
              "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": 2074.6
            },
            {
              "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": 1859.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 2530,
              "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": 2150.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 342.5,
              "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": 1391.5
            },
            {
              "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": 2074.6
            },
            {
              "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": 335.65,
              "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": 2530,
              "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": 2530,
              "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": 2226.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2530,
              "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": 339.01,
              "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": 2218.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 2530,
              "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": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "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": 2074.6
            },
            {
              "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": 335.65,
              "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": 73.2,
              "estimated_amount": 1851.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1851.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 554.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1846.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 1644.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1846.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1859.55
            },
            {
              "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": 339.01,
              "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": 1647.03
            },
            {
              "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": 1851.96
            },
            {
              "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": 342.5,
              "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": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "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": 1859.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2530,
              "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": 2530,
              "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": 1391.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2074.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2046.77
            },
            {
              "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": 2530,
              "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": 2530,
              "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": 2097.37
            },
            {
              "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": 1846.9
            },
            {
              "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": 339.01,
              "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": 2218.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1897.5
            },
            {
              "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": 2150.5
            },
            {
              "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": 2530,
              "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": 335.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "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": 335.65,
              "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": 73.6,
              "estimated_amount": 1862.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2150.5
            },
            {
              "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": 1859.55
            },
            {
              "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": 352.43,
              "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": 2150.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC MRI Low Extremity Joint W WO Contrast",
      "code_information": [
        {
          "code": "PX-61400018",
          "type": "CDM"
        },
        {
          "code": "73723",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2258,
          "discounted_cash": 1467.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1241.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2258
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 352.43,
              "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": 494.5
            },
            {
              "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": 1241.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "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": 342.5,
              "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": 1648.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1648.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2258,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1652.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1919.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1241.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1851.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1919.3
            },
            {
              "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": 335.65,
              "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": 1919.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1826.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1469.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1851.56
            },
            {
              "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": 352.43,
              "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": 1919.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1919.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1919.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1469.96
            },
            {
              "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": 1851.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1693.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1919.3
            },
            {
              "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": 2258,
              "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": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1851.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1659.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1652.86
            },
            {
              "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": 1871.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 2258,
              "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": 2258,
              "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": 1693.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1469.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1648.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "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": 1659.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1919.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1919.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1851.56
            },
            {
              "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": 1661.89
            },
            {
              "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": 1652.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 2258,
              "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": 1987.04
            },
            {
              "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": 352.43,
              "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": 335.65,
              "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": 2258,
              "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": 1241.9
            },
            {
              "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": 1659.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1652.86
            },
            {
              "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": 342.5,
              "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": 1851.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1871.88
            },
            {
              "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": 335.65,
              "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": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1652.86
            },
            {
              "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": 1652.86
            },
            {
              "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": 1661.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 73.5,
              "estimated_amount": 1659.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1693.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1652.86
            },
            {
              "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": 1980.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1919.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1648.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1648.34
            },
            {
              "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": 339.01,
              "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": 1652.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1648.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1469.96
            },
            {
              "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": 1826.72
            },
            {
              "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": 616.43
            },
            {
              "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": 335.65,
              "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": 1919.3
            },
            {
              "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": 339.01,
              "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": 2258,
              "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": 1919.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1469.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1851.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1241.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1919.3
            },
            {
              "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": 339.01,
              "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": 2258,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1241.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1919.3
            },
            {
              "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": 339.01,
              "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": 342.5,
              "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": 1467.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1871.88
            },
            {
              "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": 1980.27
            },
            {
              "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": 1851.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2258,
              "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": 1241.9
            },
            {
              "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": 339.01,
              "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": 73.6,
              "estimated_amount": 1661.89
            },
            {
              "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": 2258,
              "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": 2258,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mra Chest W and WO Contrast",
      "code_information": [
        {
          "code": "PX-61800008",
          "type": "CDM"
        },
        {
          "code": "71555",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2656,
          "discounted_cash": 1726.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "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": 1729.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1460.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 342.5,
              "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": 2257.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2656,
              "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": 1460.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1460.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1729.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2201.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 1729.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 1938.88
            },
            {
              "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": 2329.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2257.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2656
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1944.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1460.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1938.88
            },
            {
              "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": 339.01,
              "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": 1944.19
            },
            {
              "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": 339.01,
              "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": 339.01,
              "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": 2177.92
            },
            {
              "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": 2177.92
            },
            {
              "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": 339.01,
              "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": 2329.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "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": 1954.82
            },
            {
              "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": 335.65,
              "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": 2257.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2257.6
            },
            {
              "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": 2337.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "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": 2656,
              "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": 1992
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1460.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2257.6
            },
            {
              "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": 335.65,
              "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": 352.43,
              "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": 335.65,
              "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": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "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": 2201.82
            },
            {
              "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": 2257.6
            },
            {
              "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": 1952.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1938.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 2257.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 2656,
              "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": 2257.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1938.88
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 236.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 248.21,
              "additional_payer_notes": "PHYSICIAN 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": 2656,
              "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": 2656,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 581.66
            },
            {
              "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": 2177.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1944.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2148.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 2656,
              "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": 2257.6
            },
            {
              "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": 2656,
              "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": 725.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1992
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 2257.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2257.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2201.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1992
            },
            {
              "payer_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": 1954.82
            },
            {
              "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": 1729.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2177.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 342.5,
              "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": 335.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1952.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1944.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2257.6
            },
            {
              "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": 1952.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2177.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1460.8
            },
            {
              "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": 2257.6
            },
            {
              "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": 2656,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1944.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 2656,
              "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": 1938.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1729.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1938.88
            },
            {
              "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": 339.01,
              "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": 352.43,
              "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": 2656,
              "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": 73.6,
              "estimated_amount": 1954.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1460.8
            },
            {
              "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": 1944.19
            },
            {
              "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": 1944.19
            },
            {
              "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": 2656,
              "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": 1952.16
            },
            {
              "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": 1954.82
            },
            {
              "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": 2148.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2177.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2656,
              "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": 342.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1944.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2177.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2177.92
            },
            {
              "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": 1726.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2257.6
            }
          ],
          "minimum": 236.39,
          "maximum": 236.39
        }
      ]
    },
    {
      "description": "HC Pacu L and D 1st Hour",
      "code_information": [
        {
          "code": "PX-71000004",
          "type": "CDM"
        },
        {
          "code": "71000004",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1757,
          "discounted_cash": 1142.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1127.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1127.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1317.75
            },
            {
              "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": 1493.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "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": 1142.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1127.99
            },
            {
              "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": 966.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1110.42
            },
            {
              "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": 1143.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1440.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1110.42
            },
            {
              "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": 1127.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 966.35
            },
            {
              "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": 1757,
              "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": 1110.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1110.42
            },
            {
              "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": 1540.89
            },
            {
              "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": 1421.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1143.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "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": 975.14
            },
            {
              "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": 1110.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1282.61
            },
            {
              "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": 1757,
              "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": 975.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1757
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1540.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1440.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1127.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1140.29
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1282.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1110.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1127.99
            },
            {
              "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": 1440.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1282.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1143.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 975.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 966.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "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": 1103.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1140.29
            },
            {
              "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": 1127.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1143.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1440.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "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": 1127.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1110.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1127.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1456.55
            },
            {
              "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": 1757,
              "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": 966.35
            },
            {
              "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": 1456.55
            },
            {
              "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": 1127.99
            },
            {
              "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": 1440.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1440.74
            },
            {
              "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": 479.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1140.29
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1757,
              "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": 1103.4
            },
            {
              "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": 1103.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1421.41
            },
            {
              "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": 1282.61
            },
            {
              "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": 1757,
              "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": 1546.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1317.75
            },
            {
              "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": 1440.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 966.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 966.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "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": 1127.99
            },
            {
              "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": 1143.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1282.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1127.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1440.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1317.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1103.4
            },
            {
              "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": 1493.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1456.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1282.61
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            },
            {
              "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": 975.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 966.35
            },
            {
              "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": 1110.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1140.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1493.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Esophagoscopy W Injections",
      "code_information": [
        {
          "code": "PX-75000002",
          "type": "CDM"
        },
        {
          "code": "43201",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4411,
          "discounted_cash": 2867.15,
          "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": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2426.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3220.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2920.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3220.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3617.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2920.08
            },
            {
              "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": 4411,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2920.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3617.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3308.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3568.5
            },
            {
              "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": 2787.75
            },
            {
              "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": 3749.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4411,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3220.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4411,
              "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": 2871.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2871.56
            },
            {
              "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": 3617.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4411,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "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": 3617.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3617.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4411,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3308.25
            },
            {
              "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": 3656.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2787.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3617.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2426.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2426.05
            },
            {
              "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": 4411,
              "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": 3568.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3220.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "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": 2831.86
            },
            {
              "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": 2831.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4411,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2867.15
            },
            {
              "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": 2831.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3220.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3656.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2787.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "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": 2871.56
            },
            {
              "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": 3617.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2426.05
            },
            {
              "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": 3220.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4411,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2787.75
            },
            {
              "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": 2787.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "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": 4411,
              "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": 2871.56
            },
            {
              "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": 3868.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "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": 966.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "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": 2871.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3617.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3656.72
            },
            {
              "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": 3749.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2831.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2787.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2426.05
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4411,
              "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": 2831.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3749.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2920.08
            },
            {
              "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": 2426.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2787.75
            },
            {
              "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": 3868.45
            },
            {
              "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": 2787.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2818.63
            },
            {
              "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": 3881.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2426.05
            },
            {
              "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": 1204.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3308.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Small Intestine Endoscopy W Biopsy",
      "code_information": [
        {
          "code": "PX-75000048",
          "type": "CDM"
        },
        {
          "code": "44361",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4460,
          "discounted_cash": 2899,
          "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": 2863.32
            },
            {
              "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": 2453
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4460,
              "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": 3255.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2903.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3345
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3608.14
            },
            {
              "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": 3657.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2863.32
            },
            {
              "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": 2899
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2453
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3697.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2818.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2453
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3255.8
            },
            {
              "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": 2863.32
            },
            {
              "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": 976.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2863.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3697.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3345
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3911.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2952.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2453
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2863.32
            },
            {
              "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": 4460,
              "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": 4460,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3657.2
            },
            {
              "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": 3255.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2903.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3657.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "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": 3924.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2453
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3657.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4460,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2818.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2453
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2863.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2818.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4460,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2903.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3697.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4460,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2952.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2903.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2818.72
            },
            {
              "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": 3911.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2818.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "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": 3657.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4460,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3255.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2863.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2818.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2818.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2863.32
            },
            {
              "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": 2903.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2952.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4460,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4460,
              "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": 3791
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3255.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3255.8
            },
            {
              "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": 2863.32
            },
            {
              "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": 2863.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3608.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2863.32
            },
            {
              "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": 1217.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2453
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3791
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3657.2
            },
            {
              "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": 4460,
              "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": 2863.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3657.2
            },
            {
              "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": 2818.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 2952.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2849.94
            },
            {
              "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": 3657.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3345
            }
          ]
        }
      ]
    },
    {
      "description": "HC Colonoscopy",
      "code_information": [
        {
          "code": "PX-75000095",
          "type": "CDM"
        },
        {
          "code": "45378",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4916,
          "discounted_cash": 3195.4,
          "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": 3156.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3977.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4031.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3254.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3156.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4916,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4031.12
            },
            {
              "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": 4916,
              "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": 3156.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4916,
              "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": 2703.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3588.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3200.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3106.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4031.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4916,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3106.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "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": 4916,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3106.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3254.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2703.8
            },
            {
              "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": 3156.07
            },
            {
              "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": 4916,
              "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": 3106.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4031.12
            },
            {
              "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": 4031.12
            },
            {
              "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": 1342.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4916,
              "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": 3588.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4031.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3687
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3106.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3156.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3200.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "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": 3195.4
            },
            {
              "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": 1076.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3588.68
            },
            {
              "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": 4311.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3156.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3588.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3106.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2703.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4916,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3687
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "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": 4178.6
            },
            {
              "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": 2703.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3588.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3156.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3254.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3254.39
            },
            {
              "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": 3106.91
            },
            {
              "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": 3156.07
            },
            {
              "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": 3156.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4031.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "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": 3156.07
            },
            {
              "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": 3156.07
            },
            {
              "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": 3200.32
            },
            {
              "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": 3977.04
            },
            {
              "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": 3106.91
            },
            {
              "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": 4178.6
            },
            {
              "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": 4326.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3200.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2703.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4178.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2703.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3156.07
            },
            {
              "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": 3200.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3141.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4075.36
            },
            {
              "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": 4916,
              "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": 4031.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4916,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3687
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3588.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2703.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4075.36
            },
            {
              "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": 4311.33
            },
            {
              "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": 4075.36
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ivp Ea Addl Push Same Drug or Substance",
      "code_information": [
        {
          "code": "PX-76100007",
          "type": "CDM"
        },
        {
          "code": "96376",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 237,
          "discounted_cash": 154.05,
          "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": 152.15
            },
            {
              "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE 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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "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": 64.2,
              "estimated_amount": 152.15
            },
            {
              "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": 237,
              "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": 154.29
            },
            {
              "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": 237,
              "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": 196.47
            },
            {
              "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": "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": "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 [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 194.34
            },
            {
              "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": 64.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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 HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.15
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 201.45
            },
            {
              "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": 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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.15
            },
            {
              "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": 152.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "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": 201.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 149.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 237,
              "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": 191.73
            },
            {
              "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": 237,
              "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": 154.29
            },
            {
              "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": "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 [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 130.35
            },
            {
              "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": 201.45
            },
            {
              "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": 131.54
            },
            {
              "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": 131.54
            },
            {
              "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": 237,
              "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": 152.15
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 131.54
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 152.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 173.01
            },
            {
              "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": 237,
              "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": 130.35
            },
            {
              "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": 208.56
            },
            {
              "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": 237,
              "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": 237,
              "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": 177.75
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.15
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 149.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 154.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 149.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 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 [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.15
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 149.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 152.15
            },
            {
              "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": 149.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.01
            },
            {
              "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": 149.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 237
            },
            {
              "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "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": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.15
            },
            {
              "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": 194.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 237,
              "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": 237,
              "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": 201.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 201.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "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": 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": "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 [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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 149.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 237,
              "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": 177.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 149.78
            },
            {
              "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
            }
          ]
        }
      ]
    },
    {
      "description": "HC Noninvsve Physiolgc Studies Ext Art Ltd Bilat",
      "code_information": [
        {
          "code": "PX-92100005",
          "type": "CDM"
        },
        {
          "code": "93922",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 959,
          "discounted_cash": 623.35,
          "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": 615.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 786.38
            },
            {
              "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": 112.6,
              "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": 815.15
            },
            {
              "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": 606.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 606.09
            },
            {
              "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": 606.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 815.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 615.68
            },
            {
              "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": 959,
              "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": 624.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 815.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 615.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 815.15
            },
            {
              "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": 606.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 959,
              "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": 719.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 959,
              "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": 117.06,
              "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": 615.68
            },
            {
              "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": 615.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 615.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 786.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 719.25
            },
            {
              "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": 959,
              "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": 841.04
            },
            {
              "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": 261.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 815.15
            },
            {
              "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": 843.92
            },
            {
              "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": 615.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 786.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 815.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 815.15
            },
            {
              "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": 532.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 959
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 815.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 527.45
            },
            {
              "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": 959,
              "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": 775.83
            },
            {
              "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": 786.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 615.68
            },
            {
              "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": 841.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 113.77,
              "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": 527.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 815.15
            },
            {
              "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": 959,
              "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": 615.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.07
            },
            {
              "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": 959,
              "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": 615.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 624.31
            },
            {
              "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": 111.49,
              "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": 623.35
            },
            {
              "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": 111.49,
              "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": 606.09
            },
            {
              "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": 624.31
            },
            {
              "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": 775.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 959,
              "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": 815.15
            },
            {
              "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": 112.6,
              "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": 959,
              "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": 815.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 719.25
            },
            {
              "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": 624.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 527.45
            },
            {
              "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": 700.07
            },
            {
              "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": 117.06,
              "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": 111.49,
              "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": 112.6,
              "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": 532.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 795.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 786.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 615.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 113.77,
              "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": 527.45
            },
            {
              "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": 532.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.07
            },
            {
              "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": 532.25
            },
            {
              "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": 786.38
            },
            {
              "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": 786.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 786.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 624.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 117.06,
              "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": 606.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 606.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 527.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 795.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 959,
              "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": 112.6,
              "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": 606.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 112.6,
              "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": 815.15
            },
            {
              "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": 795.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 527.45
            },
            {
              "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": 959,
              "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": 615.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 815.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 959,
              "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": 113.77,
              "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": 527.45
            },
            {
              "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": 111.49,
              "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": 815.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ss Evok Potent Up Limb",
      "code_information": [
        {
          "code": "PX-92200013",
          "type": "CDM"
        },
        {
          "code": "95925",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2305,
          "discounted_cash": 1498.25,
          "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": 1479.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1479.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.81
            },
            {
              "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": 1500.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1728.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1890.1
            },
            {
              "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": 287.65,
              "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": 276.69,
              "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": 276.69,
              "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": 273.95,
              "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": 276.69,
              "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": 2305,
              "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": 1959.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1910.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1500.56
            },
            {
              "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": 1890.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 279.54,
              "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": 2305,
              "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": 1479.81
            },
            {
              "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": 2021.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 279.54,
              "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": 1267.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2305
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1959.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.75
            },
            {
              "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": 1479.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1910.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2305,
              "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": 1500.56
            },
            {
              "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": 273.95,
              "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": 1682.65
            },
            {
              "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": 276.69,
              "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": 1456.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1864.75
            },
            {
              "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": 2305,
              "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": 1456.76
            },
            {
              "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": 2021.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1959.25
            },
            {
              "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": 2305,
              "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": 1890.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.81
            },
            {
              "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": 1479.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1890.1
            },
            {
              "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": 1890.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1959.25
            },
            {
              "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": 287.65,
              "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": 2305,
              "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": 1267.75
            },
            {
              "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": 1279.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1500.56
            },
            {
              "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": 1279.28
            },
            {
              "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": 1500.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1728.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.65
            },
            {
              "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": 1479.81
            },
            {
              "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": 1864.75
            },
            {
              "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": 1456.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1959.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 1279.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.25
            },
            {
              "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": 1959.25
            },
            {
              "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": 1959.25
            },
            {
              "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": 1682.65
            },
            {
              "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": 273.95,
              "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": 1267.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 504.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1890.1
            },
            {
              "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": 1479.81
            },
            {
              "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": 1890.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2305,
              "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": 273.95,
              "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": 2305,
              "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": 1456.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1890.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1910.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.81
            },
            {
              "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": 2305,
              "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": 1456.76
            },
            {
              "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": 279.54,
              "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": 1479.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1728.75
            },
            {
              "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": 287.65,
              "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": 2305,
              "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": 1498.25
            },
            {
              "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": 1279.28
            },
            {
              "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": 629.27
            },
            {
              "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": 276.69,
              "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": 2305,
              "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": 1479.81
            },
            {
              "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": 2028.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.76
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ot Wheelchair Training 15 Min",
      "code_information": [
        {
          "code": "PX-43000032",
          "type": "CDM"
        },
        {
          "code": "97542",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 136,
          "discounted_cash": 88.4,
          "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": 87.31
            },
            {
              "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": 115.6
            },
            {
              "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": 136,
              "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": 75.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 88.54
            },
            {
              "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": 74.8
            },
            {
              "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": 111.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 102
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 99.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 99.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 136
            },
            {
              "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": 30.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 111.52
            },
            {
              "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": 119.27
            },
            {
              "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": 136,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 31.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "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": 136,
              "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": 88.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 112.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 99.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 87.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.31
            },
            {
              "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": 115.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.31
            },
            {
              "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": 110.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 111.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 99.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 111.52
            },
            {
              "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": 30.27
            },
            {
              "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": 30.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 30.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 136,
              "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": 87.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 111.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.31
            },
            {
              "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": 75.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 30.27
            },
            {
              "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": 88.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 136,
              "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": 85.95
            },
            {
              "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": 85.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 88.54
            },
            {
              "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": 88.54
            },
            {
              "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": 85.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 88.54
            },
            {
              "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": 30.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 30.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 87.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 115.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 30.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 110.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 111.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.31
            },
            {
              "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": 87.31
            },
            {
              "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": 87.31
            },
            {
              "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": 119.27
            },
            {
              "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": 136,
              "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": 74.8
            },
            {
              "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": 30.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 85.95
            },
            {
              "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": 111.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "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": 37.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.8
            },
            {
              "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": 99.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "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": 85.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 119.68
            },
            {
              "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": 30.27
            },
            {
              "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": 30.27
            },
            {
              "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": 111.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 99.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 115.6
            },
            {
              "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": 112.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 87.31
            },
            {
              "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": 30.27
            },
            {
              "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": 136,
              "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": 87.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 136,
              "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": 136,
              "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": 136,
              "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_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": 30.27
            },
            {
              "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": 30.27
            },
            {
              "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": 136,
              "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": 75.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 112.74
            }
          ]
        }
      ]
    },
    {
      "description": "HC Reservoir Cellsaver",
      "code_information": [
        {
          "code": "PX-27200376",
          "type": "CDM"
        },
        {
          "code": "27200376",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 106,
          "discounted_cash": 68.9,
          "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": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 79.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 106,
              "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": 66.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "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": 93.28
            },
            {
              "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": 68.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.92
            },
            {
              "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": 77.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.92
            },
            {
              "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": 68.9
            },
            {
              "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": 86.92
            },
            {
              "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": 66.99
            },
            {
              "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": 66.99
            },
            {
              "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": 68.05
            },
            {
              "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": 69.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "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": 58.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 106
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.3
            },
            {
              "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": 90.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 85.75
            },
            {
              "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": 87.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "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": 92.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.92
            },
            {
              "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": 58.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "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": 68.05
            },
            {
              "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": 69.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 87.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.3
            },
            {
              "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": 106,
              "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": 79.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 58.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "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": 106,
              "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": 66.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "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": 66.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "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": 85.75
            },
            {
              "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": 86.92
            },
            {
              "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": 66.99
            },
            {
              "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": 106,
              "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": 90.1
            },
            {
              "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": 66.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.01
            },
            {
              "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": 28.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.1
            },
            {
              "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": 58.83
            },
            {
              "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": 68.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 87.87
            },
            {
              "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": 86.92
            },
            {
              "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": 58.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 79.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.3
            },
            {
              "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": 106,
              "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": 92.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 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": 77.38
            }
          ]
        }
      ]
    },
    {
      "description": "HC Heart Valve 1",
      "code_information": [
        {
          "code": "PX-27800136",
          "type": "CDM"
        },
        {
          "code": "27800136",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1625,
          "discounted_cash": 1056.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "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": 1381.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "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": 1041.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1186.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1218.75
            },
            {
              "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": 1425.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1064.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "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": 1332.5
            },
            {
              "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": 1056.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1332.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1064.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 893.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "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": 1064.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 893.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 893.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1332.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1332.5
            },
            {
              "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": 1041.63
            },
            {
              "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": 991.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "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": 1625,
              "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": 1041.63
            },
            {
              "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": 1332.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1332.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 901.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 893.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1186.25
            },
            {
              "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": 901.88
            },
            {
              "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": 1430
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1425.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1038.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 893.75
            },
            {
              "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": 1314.63
            },
            {
              "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": 901.88
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "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": 1041.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1038.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1186.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1347.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1314.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 893.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1625,
              "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": 1218.75
            },
            {
              "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": 893.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1057.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1038.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1332.5
            },
            {
              "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": 1186.25
            },
            {
              "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": 1625,
              "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": 991.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1038.38
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1186.25
            },
            {
              "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": 1347.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1347.13
            },
            {
              "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": 1057.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "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": 1332.5
            },
            {
              "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": 1064.38
            },
            {
              "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": 1625,
              "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": 1064.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1218.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1625
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 901.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1381.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1064.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1064.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1057.88
            },
            {
              "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": 1057.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1057.88
            },
            {
              "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": 1381.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1041.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 991.25
            },
            {
              "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": 1064.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1186.25
            },
            {
              "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": 1625,
              "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": 443.63
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hiv Antibody Hiv1 Hiv2",
      "code_information": [
        {
          "code": "PX-30200565",
          "type": "CDM"
        },
        {
          "code": "G0432",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 79,
          "discounted_cash": 51.35,
          "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": 50.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 67.15
            },
            {
              "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": 51.43
            },
            {
              "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": 69.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "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": 63.91
            },
            {
              "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": 21.57
            },
            {
              "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": 79,
              "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": 50.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "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": 69.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 50.72
            },
            {
              "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": 69.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "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": 51.43
            },
            {
              "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": 57.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.67
            },
            {
              "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": 79,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.5,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 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": 57.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "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": 50.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 64.78
            },
            {
              "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": 43.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 43.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "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": 49.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "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": 64.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.5,
              "estimated_amount": 18.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 43.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 43.85
            },
            {
              "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": 65.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            },
            {
              "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": 79,
              "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": 49.93
            },
            {
              "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": 49.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 49.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.41,
              "estimated_amount": 51.41
            },
            {
              "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": 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": 67.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.25
            }
          ],
          "minimum": 18.5,
          "maximum": 51.41
        }
      ]
    },
    {
      "description": "HC Pt Tx Cpt 15 Min",
      "code_information": [
        {
          "code": "PX-42000125",
          "type": "CDM"
        },
        {
          "code": "42000125",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21,
          "discounted_cash": 13.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 13.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "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": 18.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 17.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "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": 11.66
            },
            {
              "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": 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": 21,
              "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": 13.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "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": 13.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "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": 13.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.63
            },
            {
              "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": 13.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "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": 13.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.33
            },
            {
              "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": 21,
              "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": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 21,
              "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": 13.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "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": 15.33
            },
            {
              "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": 17.22
            },
            {
              "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": 5.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.41
            },
            {
              "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": 13.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "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": 13.27
            },
            {
              "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": 21,
              "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": 18.42
            },
            {
              "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": 18.42
            },
            {
              "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": 13.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "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": 16.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.22
            },
            {
              "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": 17.41
            },
            {
              "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": 11.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 21,
              "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": 13.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.55
            },
            {
              "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": 13.67
            },
            {
              "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": 17.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.27
            },
            {
              "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": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "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": 15.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.48
            },
            {
              "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": 11.66
            },
            {
              "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": 13.27
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.33
            },
            {
              "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": 13.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.75
            }
          ]
        }
      ]
    },
    {
      "description": "Allergen Specific Ige, Qt/Semi-Qt, Crude Allergen Extract, Each Sendout",
      "code_information": [
        {
          "code": "PX-30200567",
          "type": "CDM"
        },
        {
          "code": "86003",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 55,
          "discounted_cash": 35.75,
          "minimum": 5.22,
          "maximum": 19.58,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "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": 45.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.27,
              "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": 34.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "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": 30.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.25
            },
            {
              "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": 46.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.22,
              "estimated_amount": 5.22
            },
            {
              "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": 48.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.22,
              "estimated_amount": 5.22
            },
            {
              "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": 48.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.22,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.22,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "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": 45.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.48,
              "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": 44.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.76
            },
            {
              "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": 55,
              "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": 30.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "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": 30.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.22,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.27,
              "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": 46.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.25
            },
            {
              "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": 46.75
            },
            {
              "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": 45.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.27,
              "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": 34.76
            },
            {
              "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": 34.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "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": 48.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.63,
              "estimated_amount": 7.63
            },
            {
              "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": 30.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "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": 46.75
            },
            {
              "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": 55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.22,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.48,
              "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": 41.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.63,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "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": 40.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.18,
              "estimated_amount": 8.18
            },
            {
              "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": 15.02
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.22,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "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": 35.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.22,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.27,
              "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": 35.81
            },
            {
              "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": 45.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 55,
              "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": 35.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.58,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.63,
              "estimated_amount": 7.63
            },
            {
              "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": 35.81
            }
          ]
        }
      ]
    },
    {
      "description": "HC Egd Esophagus Balloon Dilation 30 Mm",
      "code_information": [
        {
          "code": "PX-75000144",
          "type": "CDM"
        },
        {
          "code": "43233",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4833,
          "discounted_cash": 3141.45,
          "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": 3102.79
            },
            {
              "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": 3528.09
            },
            {
              "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": 4253.04
            },
            {
              "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": 4006.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2658.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2658.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4833,
              "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": 4833,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3199.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3199.45
            },
            {
              "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": 4108.05
            },
            {
              "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": 2658.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3528.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3054.46
            },
            {
              "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": 3054.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "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": 3146.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3963.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3624.75
            },
            {
              "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": 1319.41
            },
            {
              "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": 3054.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "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": 3141.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3528.09
            },
            {
              "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": 3963.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4006.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "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": 3102.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3963.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3528.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3963.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3528.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "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": 3102.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3199.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3054.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "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": 1058.43
            },
            {
              "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": 3054.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3146.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3963.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2658.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3054.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "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": 4833,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "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": 3963.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4833,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3624.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3909.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "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": 3102.79
            },
            {
              "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": 4238.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2658.15
            },
            {
              "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": 4108.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3054.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2658.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3528.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4833,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4833,
              "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": 3146.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3146.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4006.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3624.75
            },
            {
              "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": 4238.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 3199.45
            },
            {
              "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": 4833,
              "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": 4108.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3088.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4833,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "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": 3909.9
            },
            {
              "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": 3963.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4833,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3102.79
            },
            {
              "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": 3146.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3054.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4108.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2658.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3963.06
            },
            {
              "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": 4833,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Abg With Direct O2 Saturation",
      "code_information": [
        {
          "code": "PX-30100960",
          "type": "CDM"
        },
        {
          "code": "82805",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 111,
          "discounted_cash": 72.15,
          "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": 71.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.08,
              "estimated_amount": 32.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "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": 71.26
            },
            {
              "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": 61.61
            },
            {
              "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": 92.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 82.71,
              "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": 61.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.26
            },
            {
              "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": 70.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "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": 61.61
            },
            {
              "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": 97.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.08,
              "estimated_amount": 32.08
            },
            {
              "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": 81.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 89.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.77,
              "estimated_amount": 78.77
            },
            {
              "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": 72.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.03
            },
            {
              "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": 72.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.03
            },
            {
              "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": 111,
              "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": 91.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.77,
              "estimated_amount": 78.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 79.56,
              "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": 70.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.02
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 82.71,
              "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": 78.77,
              "estimated_amount": 78.77
            },
            {
              "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": 61.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.77,
              "estimated_amount": 78.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "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": 94.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.08,
              "estimated_amount": 32.08
            },
            {
              "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": 71.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.26
            },
            {
              "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": 61.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "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": 30.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.26
            },
            {
              "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": 72.26
            },
            {
              "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": 111,
              "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": 92.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.77,
              "estimated_amount": 78.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 82.71,
              "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": 71.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "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": 70.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.03
            },
            {
              "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": 94.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.25
            },
            {
              "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": 89.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 79.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 79.56,
              "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": 71.26
            },
            {
              "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": 91.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.26
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.77,
              "estimated_amount": 78.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 111
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 94.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.05
            },
            {
              "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": 71.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 79.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 78.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 79.56,
              "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": 97.35
            },
            {
              "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": 97.68
            },
            {
              "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": 91.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "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": 111,
              "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": 70.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 295.39,
              "estimated_amount": 295.39
            },
            {
              "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": 91.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.77,
              "estimated_amount": 78.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.05
            }
          ],
          "minimum": 32.08,
          "maximum": 295.39
        }
      ]
    },
    {
      "description": "HC Chloride Blood Amb",
      "code_information": [
        {
          "code": "PX-30100957",
          "type": "CDM"
        },
        {
          "code": "82435",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "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": 5.78
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "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": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 6.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 6.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": 7.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "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": "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": "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "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": 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": "UHC 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": "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": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 6.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "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": 5.78
            },
            {
              "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": "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": "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 STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "AVALON HEALTHREACH OH [540410]",
              "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": "MOLINA 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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "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": 7.28
            },
            {
              "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": 5.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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
            },
            {
              "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": "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 CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "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": 4.95
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "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": 5.85
            },
            {
              "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": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "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": "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": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.65,
              "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": 7.46
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.6,
              "estimated_amount": 4.6
            },
            {
              "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.25,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 5.78
            },
            {
              "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "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 MANSFIELD CITY SCHOOLS [485250]",
              "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": "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": "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 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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.6,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.83,
              "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": 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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            }
          ],
          "minimum": 4.6,
          "maximum": 17.25
        }
      ]
    },
    {
      "description": "Leg Bag Lf Twist Valve 900 Ml Preferred",
      "code_information": [
        {
          "code": "PX-CH-A1-LB900R",
          "type": "CDM"
        },
        {
          "code": "A4358",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.09,
          "discounted_cash": 2.01,
          "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": 1.98
            },
            {
              "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": 1.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 1.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "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": 2.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.09,
              "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": 2.63
            },
            {
              "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": 2.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 2.26
            },
            {
              "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": 3.09,
              "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": 1.98
            },
            {
              "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": 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": 2.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 1.7
            },
            {
              "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": 1.98
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "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": 2.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "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": 3.09,
              "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": 2.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            },
            {
              "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": 2.71
            },
            {
              "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": 3.09,
              "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": 1.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 1.98
            },
            {
              "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": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.7
            },
            {
              "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": 3.09,
              "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": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 1.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.09
            },
            {
              "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": 1.71
            },
            {
              "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": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 2.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 3.09,
              "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": 2.63
            },
            {
              "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": 2.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "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": 2.53
            },
            {
              "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": 3.09,
              "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": 3.09,
              "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": 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": 2.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.53
            },
            {
              "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": 2.71
            },
            {
              "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": 1.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.95
            },
            {
              "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": 1.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.63
            },
            {
              "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": 3.09,
              "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": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 3.09,
              "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": 1.7
            },
            {
              "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": 2.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.32
            },
            {
              "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": 3.09,
              "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": 2.63
            },
            {
              "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": 3.09,
              "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": 1.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.09,
              "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": 2.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.26
            }
          ]
        }
      ]
    },
    {
      "description": "\"Contact Drsg Silicone 3\"\" X 4\"\" Mepitel One\"",
      "code_information": [
        {
          "code": "PX-CH-SM289300",
          "type": "CDM"
        },
        {
          "code": "A6206",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.01,
          "discounted_cash": 6.51,
          "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": 6.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 10.01,
              "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": 10.01,
              "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": 8.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.21
            },
            {
              "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": 5.51
            },
            {
              "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": 10.01,
              "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": 6.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.51
            },
            {
              "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": 8.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 8.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 10.01,
              "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": 10.01,
              "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": 6.52
            },
            {
              "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": 8.21
            },
            {
              "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": 10.01,
              "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": 8.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.31
            },
            {
              "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": 5.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 6.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.43
            },
            {
              "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": 8.78
            },
            {
              "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": 7.31
            },
            {
              "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": 10.01,
              "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": 6.43
            },
            {
              "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": 6.43
            },
            {
              "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": 6.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 8.51
            },
            {
              "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": 10.01,
              "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": 10.01,
              "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": 10.01,
              "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": 8.21
            },
            {
              "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": 2.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.31
            },
            {
              "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": 10.01,
              "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": 10.01,
              "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": 8.51
            },
            {
              "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": 10.01,
              "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": 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": 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": 8.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 10.01,
              "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": 10.01,
              "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": 10.01,
              "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": 10.01,
              "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": 8.51
            },
            {
              "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": 10.01,
              "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": 6.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.33
            },
            {
              "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": 10.01,
              "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": 6.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 8.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.31
            },
            {
              "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": 8.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 6.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.21
            },
            {
              "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": 6.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.51
            },
            {
              "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": 5.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.01,
              "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": 10.01,
              "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": 8.21
            },
            {
              "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": 10.01,
              "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": 8.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.51
            },
            {
              "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": 10.01,
              "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": 6.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 10.01,
              "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": 8.3
            },
            {
              "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": 8.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 6.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 7.51
            },
            {
              "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": 5.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 5.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.56
            },
            {
              "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": 6.52
            },
            {
              "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": 10.01,
              "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": 5.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.31
            },
            {
              "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": 8.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.01,
              "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": 10.01,
              "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": 6.52
            }
          ]
        }
      ]
    },
    {
      "description": "HC Peripheral Arterial Diseas (Pad) Rehabilitation, per Session",
      "code_information": [
        {
          "code": "PX-48000072",
          "type": "CDM"
        },
        {
          "code": "93668",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 177,
          "discounted_cash": 115.05,
          "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": 113.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.48,
              "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": 98.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.63
            },
            {
              "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": 143.19
            },
            {
              "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": 177,
              "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": 54.48,
              "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": 146.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.35
            },
            {
              "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": 111.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.86
            },
            {
              "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": 111.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 132.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "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": 53.92,
              "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": 177,
              "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": 150.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132.75
            },
            {
              "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": 53.92,
              "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": 113.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.63
            },
            {
              "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": 115.23
            },
            {
              "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": 111.86
            },
            {
              "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": 53.39,
              "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": 177,
              "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": 129.21
            },
            {
              "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": 53.92,
              "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": 150.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 129.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.21
            },
            {
              "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": 53.39,
              "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": 145.14
            },
            {
              "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": 113.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.86
            },
            {
              "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": 145.14
            },
            {
              "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": 177,
              "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": 53.92,
              "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": 113.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.21
            },
            {
              "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": 145.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.63
            },
            {
              "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": 113.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 177,
              "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": 177,
              "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": 150.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 111.86
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "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": 150.45
            },
            {
              "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": 177,
              "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": 113.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.21
            },
            {
              "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": 98.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 177
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 143.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 177,
              "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": 56.06,
              "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": 111.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "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": 155.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.06,
              "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": 155.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 177,
              "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": 113.63
            },
            {
              "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": 145.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.35
            },
            {
              "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": 53.39,
              "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": 98.24
            },
            {
              "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": 56.06,
              "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": 53.92,
              "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": 177,
              "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": 97.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 146.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 145.14
            },
            {
              "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": 146.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 129.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.23
            },
            {
              "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": 48.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 177,
              "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": 177,
              "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": 97.35
            },
            {
              "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": 177,
              "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": 98.24
            },
            {
              "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": 155.23
            },
            {
              "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": 115.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.63
            },
            {
              "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": 115.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.23
            },
            {
              "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": 150.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 177,
              "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": 54.48,
              "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": 53.39,
              "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": 177,
              "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": 145.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.14
            }
          ]
        }
      ]
    },
    {
      "description": "Nasal Cannula Curved Tip No Tubing Adult",
      "code_information": [
        {
          "code": "PX-CH-55002606",
          "type": "CDM"
        },
        {
          "code": "A4615",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.23,
          "discounted_cash": 0.8,
          "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": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.23,
              "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": 1.05
            },
            {
              "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": 1.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 0.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.23,
              "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": 0.79
            },
            {
              "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": 1.23,
              "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": 0.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.79
            },
            {
              "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": 0.8
            },
            {
              "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": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 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": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.05
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.23,
              "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": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 0.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 0.8
            },
            {
              "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": 1.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.01
            },
            {
              "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": 0.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.79
            },
            {
              "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": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 0.68
            },
            {
              "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": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.05
            },
            {
              "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": 0.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.79
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.01
            },
            {
              "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": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.23,
              "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": 1.05
            },
            {
              "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": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.05
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.23,
              "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": 0.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.05
            },
            {
              "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": 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": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.23,
              "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": 0.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.23,
              "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": 0.9
            },
            {
              "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": 0.9
            },
            {
              "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": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.79
            },
            {
              "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": 1.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.23,
              "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": 1.23,
              "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": 1.02
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.68
            },
            {
              "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": 1.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.23,
              "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": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.9
            },
            {
              "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": 0.8
            }
          ]
        }
      ]
    },
    {
      "description": "Tubular Drsg Tubigrip Size C Med Arms Sm Ankles",
      "code_information": [
        {
          "code": "PX-CH-CV1514-43",
          "type": "CDM"
        },
        {
          "code": "A6457",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.2,
          "discounted_cash": 4.03,
          "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": 3.98
            },
            {
              "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": 6.2,
              "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": 6.2,
              "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": 3.44
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "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": 5.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.44
            },
            {
              "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": 6.2,
              "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": 5.44
            },
            {
              "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": 3.98
            },
            {
              "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": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 6.2,
              "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": 5.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "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 OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 6.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.65
            },
            {
              "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": 5.27
            },
            {
              "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": "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": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 3.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "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": 6.2,
              "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": 5.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "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": 3.92
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "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": 6.2,
              "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": 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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.2,
              "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": 3.98
            },
            {
              "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 6.2,
              "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": 5.27
            },
            {
              "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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 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": 3.98
            },
            {
              "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": "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": "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": "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": "AETNA [310]",
              "plan_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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "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": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 5.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "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": 5.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 4.53
            },
            {
              "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": 3.44
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.2,
              "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": 3.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "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": 5.08
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 3.98
            },
            {
              "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": 5.08
            },
            {
              "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": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "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": 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": 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": "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 POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 6.2,
              "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": 4.65
            },
            {
              "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": 3.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 5.27
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.2,
              "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": 5.08
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 61.96,
          "discounted_cash": 40.27,
          "payers_information": [
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 50.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 61.96,
              "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": 46.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 52.67
            },
            {
              "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": 61.96,
              "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": 50.13
            },
            {
              "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": 61.96,
              "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": 61.96,
              "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": 52.67
            },
            {
              "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": 52.67
            },
            {
              "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": 61.96,
              "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": 61.96,
              "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": 39.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 61.96,
              "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": 39.78
            },
            {
              "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": 40.34
            },
            {
              "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": 34.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 39.16
            },
            {
              "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": 61.96,
              "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": 45.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 34.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 40.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 61.96
            },
            {
              "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": 61.96,
              "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": 61.96,
              "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": 61.96,
              "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": 45.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 50.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "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": 34.39
            },
            {
              "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": 34.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.36
            },
            {
              "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": 45.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 61.96,
              "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": 61.96,
              "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": 61.96,
              "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": 39.16
            },
            {
              "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": 54.34
            },
            {
              "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": 51.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "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": 39.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.16
            },
            {
              "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": 34.08
            },
            {
              "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": 61.96,
              "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": 61.96,
              "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": 64.2,
              "estimated_amount": 39.78
            },
            {
              "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": 39.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 61.96,
              "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": 61.96,
              "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": 61.96,
              "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": 61.96,
              "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": 50.13
            },
            {
              "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": 61.96,
              "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": 39.78
            },
            {
              "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": 61.96,
              "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": 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": 39.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.08
            },
            {
              "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": 61.96,
              "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": 50.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "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": 54.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 61.96,
              "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": 61.96,
              "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": 40.34
            },
            {
              "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": 16.92
            },
            {
              "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": 39.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 61.96,
              "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": 39.16
            },
            {
              "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": 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": 45.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.08
            },
            {
              "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": 50.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.23
            },
            {
              "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": 61.96,
              "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": 54.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.67
            },
            {
              "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": 39.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.78
            },
            {
              "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": 61.96,
              "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": 46.47
            },
            {
              "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": 61.96,
              "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": 52.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.36
            },
            {
              "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": 61.96,
              "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": 34.08
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ish Ea Add Probe Stain So",
      "code_information": [
        {
          "code": "PX-31000147",
          "type": "CDM"
        },
        {
          "code": "88364",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 803,
          "discounted_cash": 521.95,
          "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": 515.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 515.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 586.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "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": 803,
              "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": 682.55
            },
            {
              "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": 658.46
            },
            {
              "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": 803,
              "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": 803,
              "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": 441.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 586.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 649.63
            },
            {
              "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": 522.75
            },
            {
              "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": 803,
              "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": 515.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 522.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 586.19
            },
            {
              "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": 803,
              "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": 602.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 602.25
            },
            {
              "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": 586.19
            },
            {
              "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": 515.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 522.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 507.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 665.69
            },
            {
              "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": 507.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "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": 441.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 515.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 507.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.19,
              "estimated_amount": 56.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 441.65
            },
            {
              "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": 522.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 602.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 803
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "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": 803,
              "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": 682.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 658.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 515.53
            },
            {
              "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": 515.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 586.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 665.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 507.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 441.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 586.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 658.46
            },
            {
              "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": 803,
              "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": 507.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 658.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "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": 682.55
            },
            {
              "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": 803,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 803,
              "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": 803,
              "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": 665.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "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": 803,
              "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": 649.63
            },
            {
              "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": 803,
              "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": 658.46
            },
            {
              "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": 803,
              "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": 704.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 441.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 515.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 522.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.19,
              "estimated_amount": 56.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 445.67
            },
            {
              "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": 658.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 658.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 507.5
            },
            {
              "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": 521.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 441.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "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": 515.53
            },
            {
              "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": 507.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 441.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "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": 445.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 507.5
            },
            {
              "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": 803,
              "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": 445.67
            },
            {
              "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": 704.23
            },
            {
              "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": 803,
              "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": 515.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 515.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 658.46
            },
            {
              "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": 219.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 682.55
            },
            {
              "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": 803,
              "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": 706.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "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": 445.67
            },
            {
              "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": 515.53
            },
            {
              "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": 803,
              "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": 803,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 391.39,
              "estimated_amount": 391.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.19,
              "estimated_amount": 56.19
            }
          ],
          "minimum": 56.19,
          "maximum": 391.39
        }
      ]
    },
    {
      "description": "HC Col Chrom Incl Ms Ql/Qt Nes Each Spec So",
      "code_information": [
        {
          "code": "PX-30101366",
          "type": "CDM"
        },
        {
          "code": "82542",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2229,
          "discounted_cash": 1448.85,
          "minimum": 16.74,
          "maximum": 90.34,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1627.17
            },
            {
              "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": 1003.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 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": 1894.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "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": 1827.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1627.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.29,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.39,
              "estimated_amount": 26.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1627.17
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.39,
              "estimated_amount": 26.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1225.95
            },
            {
              "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": 1627.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.29,
              "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": 1894.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1225.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.74,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "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": 557.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1627.17
            },
            {
              "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": 1114.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            },
            {
              "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": 1827.78
            },
            {
              "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": 1827.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1003.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1627.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "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": 488.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1225.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 1671.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1827.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1003.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2229
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1225.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1003.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1671.75
            },
            {
              "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": 2229,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 1671.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1003.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1827.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1827.78
            },
            {
              "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": 1225.95
            },
            {
              "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": 2229,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 1225.95
            },
            {
              "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": 2229,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1003.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1225.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1827.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 24.33,
              "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": 1448.85
            },
            {
              "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": 1003.05
            },
            {
              "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": 1003.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.09,
              "estimated_amount": 24.09
            },
            {
              "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": 1114.5
            },
            {
              "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": 1827.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 24.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.29,
              "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": 1894.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1003.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 1003.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1894.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 90.34,
              "estimated_amount": 90.34
            },
            {
              "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": 1961.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1114.5
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 2 3/4 in Natura Invisiclose",
      "code_information": [
        {
          "code": "PX-CH-CV4164-23",
          "type": "CDM"
        },
        {
          "code": "A4425",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.47,
          "discounted_cash": 3.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "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": 3.51
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 3.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.99
            },
            {
              "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": 5.47,
              "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": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "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": 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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "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": "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": "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.47,
              "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": 3.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.47,
              "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": 5.47,
              "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": 4.65
            },
            {
              "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "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": 5.47,
              "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": 3.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "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": 5.47,
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.47,
              "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": 5.47,
              "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": 4.65
            },
            {
              "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.47,
              "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": 3.46
            },
            {
              "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": 3.46
            },
            {
              "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": 3.46
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.47,
              "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": 3.56
            },
            {
              "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": "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": "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": "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": "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "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": 4.53
            },
            {
              "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": 3.51
            },
            {
              "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": 3.56
            },
            {
              "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": 3.56
            },
            {
              "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": 4.49
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.47,
              "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": 5.47,
              "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": 5.47,
              "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": 3.51
            },
            {
              "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": 4.43
            },
            {
              "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.1
            },
            {
              "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": 5.47,
              "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": 3.51
            },
            {
              "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": 4.8
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "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 GEHA [625285]",
              "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 HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.56
            },
            {
              "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": 5.47,
              "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": 4.65
            },
            {
              "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "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 OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 5.47,
              "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": 5.47,
              "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": 4.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Tegaderm 4 in X 4 1/2 in Oval",
      "code_information": [
        {
          "code": "PX-CH-3M90611",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.04,
          "discounted_cash": 5.88,
          "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": 5.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.78
            },
            {
              "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": 9.04,
              "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": 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": 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": 6.6
            },
            {
              "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": 6.6
            },
            {
              "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": 5.71
            },
            {
              "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": 9.04,
              "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": 7.68
            },
            {
              "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": 5.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.6
            },
            {
              "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": 7.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "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": 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": 9.04,
              "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": 9.04,
              "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": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 7.68
            },
            {
              "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": 9.04,
              "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": 7.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 7.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.6
            },
            {
              "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": 5.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 5.8
            },
            {
              "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": 9.04,
              "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": 9.04,
              "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": 5.8
            },
            {
              "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": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 4.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "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": 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": 5.8
            },
            {
              "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": 9.04,
              "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": 5.8
            },
            {
              "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": 5.89
            },
            {
              "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": 7.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "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": 7.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "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": 5.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "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": 7.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "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": 9.04,
              "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": 5.71
            },
            {
              "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": 9.04,
              "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": 9.04,
              "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": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 7.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "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": 9.04,
              "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": 9.04,
              "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": 5.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.04
            },
            {
              "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": 7.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 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": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.89
            },
            {
              "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": 2.47
            },
            {
              "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": 9.04,
              "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": 7.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.04,
              "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": 9.04,
              "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": 6.6
            },
            {
              "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": 9.04,
              "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": 9.04,
              "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": 9.04,
              "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": 5.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.8
            },
            {
              "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": 9.04,
              "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": 7.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.68
            },
            {
              "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": 5.02
            },
            {
              "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": 9.04,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tpmt Nudt15 Gene Analysis Common Variants So",
      "code_information": [
        {
          "code": "PX-30101373",
          "type": "CDM"
        },
        {
          "code": "0034U",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1397,
          "discounted_cash": 908.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 470.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1047.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 628.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 470.83,
              "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": 908.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 768.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 768.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1019.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1214.58,
              "estimated_amount": 1214.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 628.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 628.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1019.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 470.83,
              "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": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1187.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 768.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 489.48,
              "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": 45,
              "estimated_amount": 628.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1187.45
            },
            {
              "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": 873.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1187.45
            },
            {
              "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": 628.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "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": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "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": 1187.45
            },
            {
              "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": 628.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 768.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1187.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1214.58,
              "estimated_amount": 1214.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "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": 628.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 873.13
            },
            {
              "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": 698.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1214.58,
              "estimated_amount": 1214.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "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": 768.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 470.83,
              "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": 45,
              "estimated_amount": 628.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 628.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1187.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1187.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 768.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1047.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "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": 1019.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 768.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1019.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1019.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "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": 1187.45
            },
            {
              "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": 305.94
            },
            {
              "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": 873.13
            },
            {
              "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": 349.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 470.83,
              "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": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "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": 698.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 489.48,
              "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": 45,
              "estimated_amount": 628.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1187.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 698.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1748.14,
              "estimated_amount": 1748.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1214.58,
              "estimated_amount": 1214.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 466.17,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 489.48,
              "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": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1019.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 873.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 466.17,
              "estimated_amount": 466.17
            }
          ],
          "minimum": 466.17,
          "maximum": 1748.14
        }
      ]
    },
    {
      "description": "HC Audiometry Pure Tone, Air Only",
      "code_information": [
        {
          "code": "PX-47100008",
          "type": "CDM"
        },
        {
          "code": "92552",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 122,
          "discounted_cash": 79.3,
          "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": 78.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 103.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 98.7
            },
            {
              "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": 100.04
            },
            {
              "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": 122,
              "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": 89.06
            },
            {
              "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": 122,
              "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": 77.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 100.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 78.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 91.5
            },
            {
              "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": 122,
              "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": 107.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "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": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 103.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "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": 100.04
            },
            {
              "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": 77.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 100.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "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": 67.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 103.7
            },
            {
              "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": 79.42
            },
            {
              "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": 33.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 122,
              "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": 67.1
            },
            {
              "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": 67.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122,
              "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": 103.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 122
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 78.32
            },
            {
              "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": 78.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 101.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 78.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "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": 67.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "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": 77.1
            },
            {
              "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": 106.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 122,
              "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": 122,
              "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": 67.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 101.14
            },
            {
              "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": 98.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 78.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.7
            },
            {
              "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": 122,
              "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": 67.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 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": 89.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.06
            },
            {
              "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": 79.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.04
            },
            {
              "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": 106.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 122,
              "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": 103.7
            },
            {
              "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": 79.42
            },
            {
              "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": 101.14
            },
            {
              "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": 78.32
            }
          ]
        }
      ]
    },
    {
      "description": "\"1pc Ctf Std Wear 3/8\"\" to 2-1/8\"\"\"",
      "code_information": [
        {
          "code": "PX-CH-CO10489",
          "type": "CDM"
        },
        {
          "code": "A5061",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.89,
          "discounted_cash": 3.18,
          "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": 3.14
            },
            {
              "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": 3.09
            },
            {
              "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": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.89,
              "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": 4.89,
              "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": 4.16
            },
            {
              "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": 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": 3.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 3.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.89,
              "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": 3.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.69
            },
            {
              "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": 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": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 2.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.57
            },
            {
              "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": 3.57
            },
            {
              "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": 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": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.57
            },
            {
              "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": 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": 4.89,
              "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": 4.89,
              "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": 4.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.18
            },
            {
              "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": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.89,
              "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": 4.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 4.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 3.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 4.01
            },
            {
              "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": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.89,
              "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": 3.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.01
            },
            {
              "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": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.89,
              "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": 4.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.14
            },
            {
              "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": 4.01
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.89
            },
            {
              "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": 2.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 2.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.18
            },
            {
              "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": 3.14
            },
            {
              "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": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.69
            },
            {
              "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": 4.89,
              "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": 4.89,
              "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": 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": 2.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.16
            },
            {
              "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": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.89,
              "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": 4.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.57
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Xtrasorb 4.5 in X 4.5 In",
      "code_information": [
        {
          "code": "PX-CH-DUM86244",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.94,
          "discounted_cash": 5.81,
          "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": 5.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.82
            },
            {
              "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": 8.94,
              "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": 7.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.53
            },
            {
              "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": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 7.6
            },
            {
              "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": 8.94,
              "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": 5.82
            },
            {
              "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": 5.74
            },
            {
              "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": 7.33
            },
            {
              "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": 8.94,
              "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": 7.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.65
            },
            {
              "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": 7.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 7.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.53
            },
            {
              "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": 8.94,
              "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": 5.74
            },
            {
              "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": 8.94,
              "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": 7.6
            },
            {
              "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": 8.94,
              "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": 8.94,
              "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": 4.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.74
            },
            {
              "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": 5.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.96
            },
            {
              "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": 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": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 7.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.94
            },
            {
              "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": 7.41
            },
            {
              "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": 8.94,
              "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": 8.94,
              "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": 5.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 7.6
            },
            {
              "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": 5.74
            },
            {
              "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": 8.94,
              "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": 8.94,
              "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": 8.94,
              "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": 5.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.71
            },
            {
              "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": 8.94,
              "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": 8.94,
              "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": 6.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.6
            },
            {
              "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": 4.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.33
            },
            {
              "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": 7.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.33
            },
            {
              "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": 8.94,
              "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": 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": 2.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 7.6
            },
            {
              "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": 8.94,
              "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": 5.74
            },
            {
              "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": 4.96
            },
            {
              "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": 8.94,
              "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": 8.94,
              "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": 5.65
            },
            {
              "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": 5.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 8.94,
              "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": 8.94,
              "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": 7.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.94,
              "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": 7.87
            },
            {
              "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": 7.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.53
            },
            {
              "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": 8.94,
              "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": 5.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 7.23
            },
            {
              "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": 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": 7.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.65
            },
            {
              "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": 7.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 8.94,
              "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": 8.94,
              "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": 5.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.94,
              "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": 7.6
            },
            {
              "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": 4.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.6
            },
            {
              "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": 8.94,
              "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": 4.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.92
            },
            {
              "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": 5.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 6.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.82
            },
            {
              "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": 8.94,
              "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": 8.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mopath Unlisted So",
      "code_information": [
        {
          "code": "PX-30101376",
          "type": "CDM"
        },
        {
          "code": "81479",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1582,
          "discounted_cash": 1028.3,
          "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": 1015.64
            },
            {
              "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": 993.5
            },
            {
              "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": 346.46
            },
            {
              "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": 1582,
              "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": 1154.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 870.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.86
            },
            {
              "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": 1344.7
            },
            {
              "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": 1582,
              "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": 1015.64
            },
            {
              "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": 1387.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1015.64
            },
            {
              "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": 1279.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.86
            },
            {
              "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": 878.01
            },
            {
              "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": 1029.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1297.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1297.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1297.24
            },
            {
              "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": 1297.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "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": 1387.41
            },
            {
              "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": 1582,
              "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": 870.1
            },
            {
              "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": 1297.24
            },
            {
              "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": 1344.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1297.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 999.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "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": 993.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 999.82
            },
            {
              "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": 999.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1029.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1029.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "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": 1015.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1015.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1311.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1026.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "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": 1028.3
            },
            {
              "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": 878.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 999.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1026.72
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1582,
              "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": 870.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1582
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1392.16
            },
            {
              "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": 1015.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 878.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1186.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "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": 1015.64
            },
            {
              "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": 1029.88
            },
            {
              "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": 1154.86
            },
            {
              "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": 1015.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1015.64
            },
            {
              "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": 1311.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "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": 431.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1029.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "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": 999.82
            },
            {
              "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": 993.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1026.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1186.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "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": 1297.24
            },
            {
              "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": 999.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1026.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 870.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 870.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 999.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 870.1
            },
            {
              "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": 878.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1015.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 870.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 993.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1186.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.86
            },
            {
              "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": 1582,
              "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": 1015.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1297.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1344.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 999.82
            },
            {
              "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": 1015.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1279.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1311.48
            }
          ]
        }
      ]
    },
    {
      "description": "Tray Driveline Management Lvad",
      "code_information": [
        {
          "code": "PX-CH-TRS-DM605",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39.89,
          "discounted_cash": 25.93,
          "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": 25.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.71
            },
            {
              "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": 39.89,
              "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": 33.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.61
            },
            {
              "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": 39.89,
              "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": 32.27
            },
            {
              "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": 33.91
            },
            {
              "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": 39.89,
              "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": 33.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 35.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 39.89,
              "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": 39.89,
              "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": 32.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 39.89,
              "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": 39.89,
              "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": 39.89,
              "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": 25.61
            },
            {
              "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": 32.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.21
            },
            {
              "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": 34.98
            },
            {
              "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": 10.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 39.89,
              "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": 25.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.97
            },
            {
              "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": 32.71
            },
            {
              "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": 39.89,
              "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": 63.2,
              "estimated_amount": 25.21
            },
            {
              "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": 39.89,
              "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": 33.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.12
            },
            {
              "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": 39.89,
              "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": 29.12
            },
            {
              "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": 33.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.97
            },
            {
              "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": 39.89,
              "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": 39.89,
              "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": 25.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 39.89,
              "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": 33.91
            },
            {
              "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": 22.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.89,
              "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": 33.91
            },
            {
              "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": 25.61
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 33.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.21
            },
            {
              "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": 25.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.12
            },
            {
              "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": 29.12
            },
            {
              "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": 39.89,
              "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": 39.89,
              "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": 34.98
            },
            {
              "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": 22.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.12
            },
            {
              "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": 25.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.71
            },
            {
              "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": 39.89,
              "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": 25.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 39.89,
              "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": 25.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 39.89,
              "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": 22.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.71
            },
            {
              "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": 39.89,
              "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": 39.89,
              "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": 39.89,
              "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": 64.2,
              "estimated_amount": 25.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.94
            },
            {
              "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": 25.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 33.91
            },
            {
              "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": 33.91
            },
            {
              "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": 21.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 39.89,
              "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": 25.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.71
            },
            {
              "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": 32.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 39.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.07
            },
            {
              "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": 25.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 39.89,
              "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": 39.89,
              "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": 25.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 25.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.94
            }
          ]
        }
      ]
    },
    {
      "description": "Island Composite Drsg Adhesive Medipore + Pad 3.5 X 14",
      "code_information": [
        {
          "code": "PX-CH-3M3573",
          "type": "CDM"
        },
        {
          "code": "A6220",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.8,
          "discounted_cash": 1.82,
          "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": 1.8
            },
            {
              "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": 1.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.8,
              "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": 2.38
            },
            {
              "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": 1.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "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": 1.8
            },
            {
              "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": 2.8,
              "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": 2.32
            },
            {
              "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": 2.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.38
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.8,
              "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": 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": 2.8,
              "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": 2.3
            },
            {
              "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": 2.3
            },
            {
              "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": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.8,
              "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": 2.8,
              "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": 1.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.8,
              "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": 2.38
            },
            {
              "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": 2.8,
              "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": 2.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "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": 2.8,
              "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": 2.04
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.8,
              "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": 1.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.8,
              "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": 2.8,
              "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": 2.8,
              "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": 2.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.3
            },
            {
              "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": 2.8,
              "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": 2.3
            },
            {
              "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": 1.77
            },
            {
              "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": 2.8,
              "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": 1.8
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.38
            },
            {
              "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": 2.8,
              "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": 2.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 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": 2.8,
              "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": 2.8,
              "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": 1.8
            },
            {
              "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": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.8
            },
            {
              "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": 2.8,
              "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": 1.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.77
            },
            {
              "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": 2.8,
              "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": 1.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.38
            },
            {
              "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": 2.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.1
            },
            {
              "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": 2.8,
              "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": 2.8,
              "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": 2.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.27
            },
            {
              "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": 2.8,
              "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": 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": 1.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.54
            },
            {
              "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "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": 2.8,
              "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": 2.8,
              "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": 2.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.38
            },
            {
              "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": 1.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.3
            },
            {
              "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": 1.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.8
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe Irrigation Enfit Vesco 60 Ml W/ Transistion Connector",
      "code_information": [
        {
          "code": "PX-CH-97660TC",
          "type": "CDM"
        },
        {
          "code": "A9900",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.73,
          "discounted_cash": 1.12,
          "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": 1.11
            },
            {
              "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": 1.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 1.52
            },
            {
              "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": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.73
            },
            {
              "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": 1.73,
              "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": 1.3
            },
            {
              "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": 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": 1.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.26
            },
            {
              "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": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.73,
              "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": 1.73,
              "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": 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": 1.3
            },
            {
              "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": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 0.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.43
            },
            {
              "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": 1.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.42
            },
            {
              "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": 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": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.47
            },
            {
              "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": 1.73,
              "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": 1.73,
              "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": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.11
            },
            {
              "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": 1.73,
              "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": 1.73,
              "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": 1.11
            },
            {
              "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": 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": 1.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.73,
              "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": 1.47
            },
            {
              "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": 1.73,
              "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": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 1.42
            },
            {
              "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": 1.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.73,
              "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": 1.3
            },
            {
              "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": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.42
            },
            {
              "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": 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": 1.13
            },
            {
              "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": 1.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.11
            },
            {
              "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": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "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": 1.52
            },
            {
              "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": 1.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.3
            },
            {
              "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": 1.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.42
            },
            {
              "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": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.73,
              "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": 0.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.43
            },
            {
              "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": 1.73,
              "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": 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": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.26
            },
            {
              "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": 1.73,
              "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": 1.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "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": 0.96
            },
            {
              "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": 1.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.95
            },
            {
              "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": 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": 1.47
            },
            {
              "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": 1.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "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": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 0.96
            },
            {
              "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": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 0.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.09
            },
            {
              "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": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.42
            },
            {
              "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": 1.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 1.13
            },
            {
              "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": 1.4
            },
            {
              "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": 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": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.73,
              "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": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.52
            },
            {
              "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": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.42
            },
            {
              "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": 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": 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": 0.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 1.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.09
            },
            {
              "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": 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": 0.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "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": 1.11
            },
            {
              "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": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.11
            },
            {
              "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": 1.11
            },
            {
              "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": 1.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            },
            {
              "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": 1.73,
              "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": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.73,
              "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": 1.73,
              "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": 1.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.47
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 13.23,
          "discounted_cash": 8.6,
          "payers_information": [
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 11.25
            },
            {
              "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": 7.34
            },
            {
              "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": 13.23,
              "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": 8.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 7.34
            },
            {
              "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": 13.23,
              "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": 9.66
            },
            {
              "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": 13.23,
              "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": 8.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.25
            },
            {
              "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": 8.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 13.23,
              "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": 7.28
            },
            {
              "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": 13.23,
              "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": 8.49
            },
            {
              "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": 8.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 11.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 13.23,
              "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": 9.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.28
            },
            {
              "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": 8.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.25
            },
            {
              "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": 8.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.36
            },
            {
              "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": 13.23,
              "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": 13.23,
              "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": 7.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.7
            },
            {
              "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": 11.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 10.85
            },
            {
              "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": 10.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 13.23,
              "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": 11.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.66
            },
            {
              "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": 9.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.92
            },
            {
              "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": 7.28
            },
            {
              "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": 13.23,
              "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": 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": 10.97
            },
            {
              "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": 13.23,
              "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": 11.25
            },
            {
              "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": 13.23,
              "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": 11.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.49
            },
            {
              "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": 8.49
            },
            {
              "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": 10.85
            },
            {
              "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": 11.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 11.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.25
            },
            {
              "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": 13.23,
              "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": 13.23,
              "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": 13.23,
              "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": 9.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 8.61
            },
            {
              "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": 8.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 8.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 13.23,
              "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": 13.23,
              "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": 8.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.49
            },
            {
              "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": 13.23,
              "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": 11.25
            },
            {
              "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": 10.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.28
            },
            {
              "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": 7.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 8.49
            },
            {
              "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": 8.49
            },
            {
              "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": 10.7
            },
            {
              "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": 13.23,
              "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": 13.23,
              "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": 11.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.28
            },
            {
              "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": 7.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.23,
              "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": 13.23,
              "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": 3.61
            },
            {
              "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": 13.23,
              "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": 10.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.23,
              "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": 13.23,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hereditary Cardiomyopathy Gen Seq Analys 5 Gen So",
      "code_information": [
        {
          "code": "PX-30101384",
          "type": "CDM"
        },
        {
          "code": "81439",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8535,
          "discounted_cash": 5547.75,
          "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": 5479.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6998.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7075.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4694.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8535,
              "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": 7254.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5394.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5479.47
            },
            {
              "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": 5479.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6401.25
            },
            {
              "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": 2330.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4694.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6230.55
            },
            {
              "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": 8535,
              "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": 5479.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5394.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5556.29
            },
            {
              "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": 5394.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4736.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4694.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6230.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "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": 6998.7
            },
            {
              "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": 7485.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7075.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6401.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "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": 7510.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "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": 5479.47
            },
            {
              "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": 4736.93
            },
            {
              "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": 4736.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "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": 5479.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "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": 5547.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6230.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5394.12
            },
            {
              "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": 5394.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6401.25
            },
            {
              "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": 5479.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4694.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8535
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7075.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6230.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6230.55
            },
            {
              "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": 4736.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5479.47
            },
            {
              "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": 6904.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5394.12
            },
            {
              "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": 8535,
              "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": 6998.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5479.47
            },
            {
              "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": 5556.29
            },
            {
              "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": 6998.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4694.25
            },
            {
              "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": 7254.75
            },
            {
              "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": 8535,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5556.29
            },
            {
              "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": 4694.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6904.82
            },
            {
              "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": 6230.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5479.47
            },
            {
              "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": 6998.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "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": 8535,
              "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": 5479.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6998.7
            },
            {
              "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": 7485.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5394.12
            },
            {
              "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": 7254.75
            },
            {
              "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": 5479.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6998.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7254.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4694.25
            },
            {
              "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": 5556.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2193.38,
              "estimated_amount": 2193.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5556.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6998.7
            },
            {
              "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": 5394.12
            }
          ],
          "minimum": 2193.38,
          "maximum": 2193.38
        }
      ]
    },
    {
      "description": "Imtermittent Lofric Femal Cath 14 Fr",
      "code_information": [
        {
          "code": "PX-CH3M1621",
          "type": "CDM"
        },
        {
          "code": "A6258",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.88,
          "discounted_cash": 0.57,
          "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": 0.56
            },
            {
              "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": 0.57
            },
            {
              "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": 0.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.72
            },
            {
              "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": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.88,
              "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": 0.64
            },
            {
              "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": 0.88,
              "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": 0.88,
              "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": 0.88,
              "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": 0.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.64
            },
            {
              "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": 0.72
            },
            {
              "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": 0.56
            },
            {
              "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": 0.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.75
            },
            {
              "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": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.88,
              "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": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.88,
              "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": 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": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.56
            },
            {
              "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": 0.88,
              "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": 0.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.56
            },
            {
              "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": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.88,
              "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": 0.88,
              "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": 0.56
            },
            {
              "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": 0.56
            },
            {
              "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": 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": 0.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.77
            },
            {
              "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": 0.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.66
            },
            {
              "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": 0.88,
              "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": 0.88,
              "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": 0.88,
              "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": 0.88,
              "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": 0.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.88,
              "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": 0.88,
              "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": 0.73
            },
            {
              "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": 0.56
            },
            {
              "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": 0.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.75
            },
            {
              "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": 0.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.72
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 2.02,
          "discounted_cash": 1.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.02,
              "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": 1.77
            },
            {
              "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": 1.32
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "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": 2.02,
              "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": 1.12
            },
            {
              "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": 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": 2.02,
              "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": 1.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.02,
              "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": 1.72
            },
            {
              "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": 2.02,
              "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": 1.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "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": 2.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.32
            },
            {
              "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": 2.02,
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.32
            },
            {
              "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": 1.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "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": 2.02,
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "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": 1.12
            },
            {
              "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": 2.02,
              "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": 1.63
            },
            {
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 2.02,
              "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": 2.02,
              "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": 2.02,
              "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": 1.3
            },
            {
              "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": 2.02,
              "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": 1.52
            },
            {
              "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": 0.55
            },
            {
              "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": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.67
            },
            {
              "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": 2.02,
              "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": 1.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "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": 1.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.72
            },
            {
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 1.67
            },
            {
              "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": 1.66
            },
            {
              "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": 2.02,
              "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": 2.02,
              "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": 2.02,
              "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": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "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": 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": 1.3
            },
            {
              "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": 1.11
            },
            {
              "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": 2.02,
              "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": 2.02,
              "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": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 2.02,
              "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": 1.12
            },
            {
              "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": 1.3
            },
            {
              "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": 2.02,
              "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": 2.02,
              "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": 1.47
            },
            {
              "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": 1.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.02,
              "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": 2.02,
              "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": 2.02,
              "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": 1.11
            },
            {
              "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": 2.02,
              "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": 1.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.72
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 2.06,
          "discounted_cash": 1.34,
          "payers_information": [
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 1.3
            },
            {
              "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": 2.06,
              "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": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.5
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.06,
              "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": 2.06,
              "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": 2.06,
              "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": 2.06,
              "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": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.32
            },
            {
              "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": 2.06,
              "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": 1.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.75
            },
            {
              "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": 2.06,
              "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": 1.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 1.69
            },
            {
              "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": 1.69
            },
            {
              "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": 1.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 2.06,
              "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": 1.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 2.06,
              "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": 2.06,
              "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": 1.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.13
            },
            {
              "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": 1.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 1.71
            },
            {
              "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": 1.32
            },
            {
              "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": 2.06,
              "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": 1.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 1.75
            },
            {
              "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": 2.06,
              "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": 1.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.71
            },
            {
              "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": 2.06,
              "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": 1.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 2.06,
              "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": 2.06,
              "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": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.69
            },
            {
              "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": 2.06,
              "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": 1.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 1.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.13
            },
            {
              "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": 1.32
            },
            {
              "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": 2.06,
              "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": 1.75
            },
            {
              "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": 1.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 2.06,
              "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": 1.13
            },
            {
              "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": 2.06,
              "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": 2.06,
              "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": 2.06,
              "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": 1.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 2.06,
              "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": 2.06,
              "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": 1.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 1.55
            },
            {
              "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": 1.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.06,
              "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": 1.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.32
            },
            {
              "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": 2.06,
              "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": 1.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.06,
              "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": 1.55
            },
            {
              "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": 1.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.13
            },
            {
              "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": 1.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.5
            },
            {
              "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": 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": 1.34
            },
            {
              "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": 0.56
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.5
            },
            {
              "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": 1.3
            },
            {
              "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": 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": 1.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.75
            }
          ]
        }
      ]
    },
    {
      "description": "HC Nerve Conduction Studies 5-6",
      "code_information": [
        {
          "code": "PX-92200025",
          "type": "CDM"
        },
        {
          "code": "95909",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2215,
          "discounted_cash": 1439.75,
          "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": 1422.03
            },
            {
              "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": 1816.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1616.95
            },
            {
              "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": 273.95,
              "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": 2215,
              "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": 2215,
              "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": 1616.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1882.75
            },
            {
              "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": 273.95,
              "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": 1836.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 2215
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1882.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1422.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1882.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1422.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1616.95
            },
            {
              "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": 1882.75
            },
            {
              "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": 1422.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1218.25
            },
            {
              "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": 276.69,
              "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": 1791.94
            },
            {
              "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": 1816.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 2215,
              "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": 279.54,
              "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": 1816.3
            },
            {
              "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": 1942.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 1882.75
            },
            {
              "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": 604.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1836.24
            },
            {
              "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": 276.69,
              "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": 279.54,
              "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": 1882.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1791.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1422.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1441.97
            },
            {
              "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": 279.54,
              "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": 1229.33
            },
            {
              "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": 276.69,
              "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": 1949.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1399.88
            },
            {
              "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": 1218.25
            },
            {
              "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": 2215,
              "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": 1422.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1882.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1399.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1229.33
            },
            {
              "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": 1942.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1441.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2215,
              "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": 2215,
              "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": 1661.25
            },
            {
              "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": 2215,
              "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": 1218.25
            },
            {
              "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": 1229.33
            },
            {
              "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": 1422.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1218.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1816.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1882.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1616.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1399.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 1882.75
            },
            {
              "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": 1229.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1616.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1882.75
            },
            {
              "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": 1836.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1422.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1399.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 1882.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1218.25
            },
            {
              "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": 1399.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 1422.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1422.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1441.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 1882.75
            },
            {
              "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": 1439.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1661.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1422.03
            },
            {
              "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": 287.65,
              "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": 2215,
              "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": 1441.97
            },
            {
              "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": 273.95,
              "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": 1218.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1218.25
            },
            {
              "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": 276.69,
              "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": 485.09
            },
            {
              "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": 276.69,
              "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": 1422.03
            },
            {
              "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": 1816.3
            },
            {
              "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": 1399.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1399.88
            },
            {
              "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": 2215,
              "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": 1616.95
            },
            {
              "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": 1399.88
            },
            {
              "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": 2215,
              "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": 1816.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1882.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1816.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1816.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2215,
              "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": 2215,
              "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": 2215,
              "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": 287.65,
              "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": 1661.25
            },
            {
              "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": 273.95,
              "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": 2215,
              "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": 1441.97
            },
            {
              "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": 2215,
              "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": 1882.75
            },
            {
              "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": 287.65,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Natural Killer Cells Total CT So",
      "code_information": [
        {
          "code": "PX-30200642",
          "type": "CDM"
        },
        {
          "code": "86357",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 51,
          "discounted_cash": 33.15,
          "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": 32.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 44.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.72,
              "estimated_amount": 55.72
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.72,
              "estimated_amount": 55.72
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.92
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "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": 37.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "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": 32.74
            },
            {
              "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": 41.26
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "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": 32.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "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": 51,
              "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": 32.74
            },
            {
              "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": 44.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.28
            },
            {
              "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": "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": "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": "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 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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.62,
              "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": 38.25
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 28.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "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": 28.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "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": 43.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.28
            },
            {
              "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": 32.23
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "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": 43.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.73,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 32.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 39.62,
              "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": 37.73,
              "estimated_amount": 37.73
            },
            {
              "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": 28.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "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": 32.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.72,
              "estimated_amount": 55.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 28.31
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "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": 32.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 33.15
            },
            {
              "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": 41.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 141.49,
              "estimated_amount": 141.49
            },
            {
              "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": 33.2
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 28.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 37.73,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 38.11,
              "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": 43.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.23
            },
            {
              "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": 41.82
            },
            {
              "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": 42.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "MOLINA 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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            }
          ],
          "minimum": 37.73,
          "maximum": 141.49
        }
      ]
    },
    {
      "description": "HC Fine Needle Asp Biopsy W CT Ea Addl Lesion",
      "code_information": [
        {
          "code": "PX-36100923",
          "type": "CDM"
        },
        {
          "code": "10010",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2704,
          "discounted_cash": 1757.6,
          "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": 1735.97
            },
            {
              "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": 1735.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1973.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1973.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1708.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2241.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1735.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1487.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2217.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2028
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1708.93
            },
            {
              "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": 2217.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1735.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1708.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2298.4
            },
            {
              "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": 1735.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2704,
              "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": 2371.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2704,
              "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": 1757.6
            },
            {
              "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": 1487.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1708.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1487.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1487.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1973.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2217.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2217.28
            },
            {
              "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": 738.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1487.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2704,
              "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": 1708.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1760.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1708.93
            },
            {
              "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": 1708.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1735.97
            },
            {
              "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": 2217.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2298.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1760.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "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": 2704,
              "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": 2704,
              "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": 2217.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1487.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2187.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2028
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "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": 1973.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2704,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2241.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2241.62
            },
            {
              "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": 2704,
              "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": 2704,
              "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": 1735.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2379.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1735.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2217.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2217.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1973.92
            },
            {
              "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": 2298.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1735.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2028
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "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": 1708.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1973.92
            },
            {
              "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": 2704,
              "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": 1735.97
            },
            {
              "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": 1760.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2704,
              "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": 2704,
              "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": 1487.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2298.4
            },
            {
              "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": 2704,
              "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": 1735.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1735.97
            },
            {
              "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": 2371.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 2187.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1760.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2704,
              "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": 1760.3
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Subq Cardiac Rhythm Monitor Incl Programming",
      "code_information": [
        {
          "code": "PX-36100935",
          "type": "CDM"
        },
        {
          "code": "33285",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 19702,
          "discounted_cash": 12806.3,
          "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": 12648.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "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": 10836.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14382.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12451.66
            },
            {
              "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": 19702,
              "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": 16746.7
            },
            {
              "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": 16746.7
            },
            {
              "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": 17278.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 19702
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7489.05,
              "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": 7414.9,
              "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": 7785.65,
              "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": 16332.96
            },
            {
              "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": 7566.23,
              "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": 12826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12648.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14382.46
            },
            {
              "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": 12648.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 19702,
              "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": 16155.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 19702
            },
            {
              "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": 3546.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12451.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "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": 12648.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12826
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10836.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10836.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 7566.23,
              "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": 19702,
              "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": 7489.05,
              "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": 7414.9,
              "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": 12826
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14776.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10836.1
            },
            {
              "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": 7489.05,
              "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": 17278.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 12648.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16155.64
            },
            {
              "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": 12648.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 19702,
              "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": 19702,
              "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": 14382.46
            },
            {
              "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": 12451.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 10836.1
            },
            {
              "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": 5378.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14382.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12648.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12451.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "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": 7785.65,
              "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": 10836.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19702,
              "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": 7489.05,
              "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": 16746.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "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": 16155.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16155.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 17337.76
            },
            {
              "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": 7785.65,
              "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": 16746.7
            },
            {
              "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": 12826
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16155.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 12806.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 19702,
              "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": 16155.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14776.5
            },
            {
              "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": 7414.9,
              "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": 7566.23,
              "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": 4314.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "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": 14382.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "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": 12451.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16332.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10836.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14382.46
            },
            {
              "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": 7489.05,
              "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": 16332.96
            },
            {
              "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": 12648.68
            },
            {
              "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": 12648.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15938.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16155.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12451.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 19702,
              "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": 19702,
              "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": 12648.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 19702
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 19702
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "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": 7414.9,
              "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": 12451.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16746.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12648.68
            },
            {
              "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": 12826
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3546.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14776.5
            },
            {
              "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": 16746.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12451.66
            },
            {
              "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": 16155.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 19702
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15938.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 19702,
              "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": 12648.68
            }
          ]
        }
      ]
    },
    {
      "description": "Atn1 Gene Analysis Evaluation to Detect Abnormal Alleles Sendout",
      "code_information": [
        {
          "code": "PX-30101396",
          "type": "CDM"
        },
        {
          "code": "81177",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1785,
          "discounted_cash": 1160.25,
          "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": 64.2,
              "estimated_amount": 1145.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1128.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1303.05
            },
            {
              "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": 1162.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1479.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1463.7
            },
            {
              "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": 1463.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "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": 990.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1162.04
            },
            {
              "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": 1785,
              "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": 1145.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1128.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1128.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1145.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 981.75
            },
            {
              "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": 1444.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 990.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1162.04
            },
            {
              "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": 1145.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1517.25
            },
            {
              "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": 1517.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "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": 1463.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1463.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1128.12
            },
            {
              "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": 1565.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "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": 1565.45
            },
            {
              "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": 1128.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1303.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1145.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1145.97
            },
            {
              "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": 990.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "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": 1570.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "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": 1463.7
            },
            {
              "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": 487.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1145.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1303.05
            },
            {
              "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": 1479.77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1303.05
            },
            {
              "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": 1517.25
            },
            {
              "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": 1145.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "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": 981.75
            },
            {
              "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": 1785,
              "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": 1145.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1162.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1128.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1303.05
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1785,
              "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": 990.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1444.07
            },
            {
              "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": 1303.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1785
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1463.7
            },
            {
              "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": 1785,
              "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": 1145.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1785,
              "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": 1128.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "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": 1160.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1463.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1463.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 981.75
            },
            {
              "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": 1145.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1145.97
            },
            {
              "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": 1128.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 981.75
            },
            {
              "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": 1162.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1479.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1517.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 513.75,
              "estimated_amount": 513.75
            }
          ],
          "minimum": 513.75,
          "maximum": 513.75
        }
      ]
    },
    {
      "description": "HC Smn1 Gene Analysis Full Gene Sequence So",
      "code_information": [
        {
          "code": "PX-30101428",
          "type": "CDM"
        },
        {
          "code": "81336",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1928,
          "discounted_cash": 1253.2,
          "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": 1237.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1407.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1638.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1580.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1446
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1070.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1070.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1255.13
            },
            {
              "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": 526.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1237.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1580.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1928,
              "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": 1060.4
            },
            {
              "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": 1598.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1237.78
            },
            {
              "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": 1255.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1218.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1696.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1446
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "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": 1253.2
            },
            {
              "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": 1237.78
            },
            {
              "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": 1580.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1580.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1255.13
            },
            {
              "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": 1559.75
            },
            {
              "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": 1070.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1060.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1598.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1237.78
            },
            {
              "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": 1237.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1580.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1060.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1218.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1407.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1407.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1237.78
            },
            {
              "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": 1070.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1237.78
            },
            {
              "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": 1580.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1218.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1060.4
            },
            {
              "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": 1407.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1407.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1255.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1255.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "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": 1928,
              "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": 1446
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1580.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1218.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1060.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1237.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1407.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1060.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "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": 1690.86
            },
            {
              "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": 1218.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1928,
              "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": 1218.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1218.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1060.4
            },
            {
              "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": 1237.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "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": 1218.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1928,
              "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": 1928,
              "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": 1237.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1638.8
            },
            {
              "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": 1638.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1598.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1580.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1928
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1237.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1130.06,
              "estimated_amount": 1130.06
            },
            {
              "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": 1690.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1559.75
            }
          ],
          "minimum": 1130.06,
          "maximum": 1130.06
        }
      ]
    },
    {
      "description": "Inserts Cvx 7-8 in X 1 1-2in Oval Adapt Rings",
      "code_information": [
        {
          "code": "PX-CHHO79601",
          "type": "CDM"
        },
        {
          "code": "A4411",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.74,
          "discounted_cash": 3.73,
          "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": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 3.19
            },
            {
              "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": 5.74,
              "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": 4.71
            },
            {
              "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": 5.74,
              "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": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 5.74,
              "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": 3.19
            },
            {
              "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": 4.88
            },
            {
              "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 PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.31
            },
            {
              "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": 5.74,
              "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": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 4.19
            },
            {
              "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": 3.74
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.74,
              "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": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 3.16
            },
            {
              "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": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 5.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.71
            },
            {
              "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": 1.57
            },
            {
              "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 BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.19
            },
            {
              "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": 5.03
            },
            {
              "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": 3.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 3.74
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.74,
              "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": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "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": "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": 5.74,
              "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": 3.69
            },
            {
              "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": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.88
            },
            {
              "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": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 3.16
            },
            {
              "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": 4.19
            },
            {
              "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": 5.74,
              "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": 5.74,
              "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": 5.74,
              "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": 4.76
            },
            {
              "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": "AETNA [310]",
              "plan_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": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.88
            },
            {
              "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": 5.74,
              "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": 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": 4.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.76
            },
            {
              "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": 4.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.76
            },
            {
              "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": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.88
            },
            {
              "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": 5.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 4.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.74
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.74,
              "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": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.74,
              "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": 5.74,
              "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": 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": 3.74
            },
            {
              "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": 5.74,
              "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": 3.16
            },
            {
              "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": "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": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 4.88
            },
            {
              "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": 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": 4.71
            },
            {
              "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": 3.19
            }
          ]
        }
      ]
    },
    {
      "description": "Foley Insertion Tray 10cc Syringe Tray Only",
      "code_information": [
        {
          "code": "PX-CHBA802010",
          "type": "CDM"
        },
        {
          "code": "A4310",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.49,
          "discounted_cash": 1.62,
          "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": 1.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.04
            },
            {
              "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": 2.49,
              "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": 2.12
            },
            {
              "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": 1.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "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": 2.49,
              "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": 2.49,
              "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": 1.57
            },
            {
              "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": 2.49,
              "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": 2.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "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": 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": 1.6
            },
            {
              "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": 1.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.6
            },
            {
              "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": 1.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.49,
              "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": 2.49,
              "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": 1.6
            },
            {
              "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": 2.49,
              "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": 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": 2.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.6
            },
            {
              "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": 2.49,
              "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": 1.82
            },
            {
              "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": 2.49,
              "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": 63.2,
              "estimated_amount": 1.57
            },
            {
              "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": 1.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.6
            },
            {
              "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": 2.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 1.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "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": 1.6
            },
            {
              "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": 2.18
            },
            {
              "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": 2.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.49,
              "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": 1.62
            },
            {
              "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": 2.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.49,
              "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": 2.04
            },
            {
              "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": 2.49,
              "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": 2.49,
              "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": 1.6
            },
            {
              "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": 2.49,
              "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": 2.06
            },
            {
              "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": 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": 1.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.49,
              "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": 2.49,
              "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": 2.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "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": 2.06
            },
            {
              "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": 2.49,
              "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": 2.49,
              "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": 1.62
            },
            {
              "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": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.19
            },
            {
              "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": 1.38
            },
            {
              "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": 1.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.37
            },
            {
              "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": 2.49,
              "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": 2.49,
              "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": 1.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.49,
              "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": 1.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.49,
              "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": 1.82
            },
            {
              "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": 2.49,
              "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": 2.49,
              "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": 1.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.12
            },
            {
              "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": 1.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 2.49,
              "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": 1.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.49,
              "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": 1.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.82
            }
          ]
        }
      ]
    },
    {
      "description": "HC Potassium Amb",
      "code_information": [
        {
          "code": "PX-30100969",
          "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": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "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": "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": "HUMANA [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": "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": "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": "GENERAL AMERICAN LIFE OHCP [535220]",
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.76,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.76,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.81,
              "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
            },
            {
              "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 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": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "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": 7.89
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "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": 5.69
            },
            {
              "payer_name": "MOLINA 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": "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": "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": "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": "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 MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "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 ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 4.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": 7.46
            },
            {
              "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": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.76,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.81,
              "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": 7.46
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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": 7.28
            },
            {
              "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": "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": 7.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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": 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": "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": "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 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 [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 7.65
            },
            {
              "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": "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": "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 MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "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": "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": "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": "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 POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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": "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 [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 UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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 [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": 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": 7.38
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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": 6.57
            },
            {
              "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": 7.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.76,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.76,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.81,
              "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": 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": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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
            },
            {
              "payer_name": "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": "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": "AETNA [310]",
              "plan_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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "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": "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 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": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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": "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/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "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 HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "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": "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "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": 2.46
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            }
          ],
          "minimum": 4.76,
          "maximum": 17.85
        }
      ]
    },
    {
      "description": "Suction Canister 850 Cc Float Lid and Tubing",
      "code_information": [
        {
          "code": "PX-CHMZHCS7851",
          "type": "CDM"
        },
        {
          "code": "A7000",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.52,
          "discounted_cash": 5.54,
          "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": 5.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.06
            },
            {
              "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": 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": 7.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 8.52,
              "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": 7.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 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": 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": 6.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 6.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 5.47
            },
            {
              "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": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 4.73
            },
            {
              "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": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 6.22
            },
            {
              "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": 4.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 8.52,
              "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": 2.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 4.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 6.39
            },
            {
              "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": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 8.52,
              "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": 7.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.47
            },
            {
              "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": 5.47
            },
            {
              "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": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 4.69
            },
            {
              "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": 6.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 6.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.24
            },
            {
              "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": 5.47
            },
            {
              "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": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 8.52,
              "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": 8.52,
              "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": 7.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 5.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.52
            },
            {
              "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": 4.73
            },
            {
              "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": 7.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.47
            },
            {
              "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": 5.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 6.99
            },
            {
              "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": 8.52,
              "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": 6.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 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": 6.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.47
            },
            {
              "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": 5.55
            },
            {
              "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": 5.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "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": 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": 7.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "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": 7.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch Closed W Filter Sensura Mio Flex 70mm Yellow",
      "code_information": [
        {
          "code": "PX-CHCO12222",
          "type": "CDM"
        },
        {
          "code": "A4419",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.4,
          "discounted_cash": 1.56,
          "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": 1.54
            },
            {
              "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": 1.97
            },
            {
              "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": 1.97
            },
            {
              "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": 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": 2.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.04
            },
            {
              "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": 1.56
            },
            {
              "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": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.75
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 2.4,
              "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": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.52
            },
            {
              "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": 1.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.4,
              "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": 2.4,
              "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": 2.4,
              "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": 1.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.75
            },
            {
              "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": 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": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 1.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.99
            },
            {
              "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": 1.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.54
            },
            {
              "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": 2.1
            },
            {
              "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": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 2.4
            },
            {
              "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": 2.4,
              "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": 1.97
            },
            {
              "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": 2.4,
              "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": 1.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.4,
              "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": 1.94
            },
            {
              "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": 1.97
            },
            {
              "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": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 1.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.75
            },
            {
              "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": 1.33
            },
            {
              "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": 2.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 1.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 2.4,
              "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": 2.4,
              "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": 1.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.54
            },
            {
              "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": 1.75
            },
            {
              "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": 2.4,
              "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": 1.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.32
            },
            {
              "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": 2.4,
              "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": 2.4,
              "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": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 1.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.54
            },
            {
              "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": 1.54
            },
            {
              "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": 1.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.97
            },
            {
              "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": 1.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.4,
              "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": 2.4,
              "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": 1.56
            }
          ]
        }
      ]
    },
    {
      "description": "HC Kit Stem Cell",
      "code_information": [
        {
          "code": "PX-27200429",
          "type": "CDM"
        },
        {
          "code": "27200429",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3206,
          "discounted_cash": 2083.9,
          "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": 2058.25
            },
            {
              "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": 2013.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "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": 2058.25
            },
            {
              "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": 1779.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2593.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2628.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1763.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2058.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "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": 2811.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2026.19
            },
            {
              "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": 2628.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1763.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2340.38
            },
            {
              "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": 2811.66
            },
            {
              "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": 2013.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2080.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2404.5
            },
            {
              "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": 2628.92
            },
            {
              "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": 2026.19
            },
            {
              "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": 1779.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "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": 2725.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2087.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2026.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2026.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2080.69
            },
            {
              "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": 2340.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2058.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2628.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "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": 1779.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "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": 1763.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2340.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2340.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2340.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2058.25
            },
            {
              "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": 2087.11
            },
            {
              "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": 3206,
              "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": 2058.25
            },
            {
              "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": 2026.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1763.3
            },
            {
              "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": 2013.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2080.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1779.33
            },
            {
              "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": 3206,
              "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": 2725.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1763.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1763.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2026.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2340.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2026.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3206,
              "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": 2013.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2404.5
            },
            {
              "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": 3206,
              "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": 2628.92
            },
            {
              "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": 3206,
              "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": 2026.19
            },
            {
              "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": 2087.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2628.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2657.77
            },
            {
              "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": 2657.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2058.25
            },
            {
              "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": 2058.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2087.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2725.1
            },
            {
              "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": 2058.25
            },
            {
              "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": 2058.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2058.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2404.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2058.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2087.11
            },
            {
              "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": 2593.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2628.92
            },
            {
              "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": 2821.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2080.69
            },
            {
              "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": 2083.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2013.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3206
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1763.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2628.92
            },
            {
              "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": 875.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2657.77
            }
          ]
        }
      ]
    },
    {
      "description": "HC Kit Midline Catheter Basic",
      "code_information": [
        {
          "code": "PX-27200425",
          "type": "CDM"
        },
        {
          "code": "C1751",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 217,
          "discounted_cash": 141.05,
          "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": 139.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 141.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 184.45
            },
            {
              "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": 137.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 184.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 162.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 141.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 217,
              "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": 217,
              "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": 217,
              "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": 217,
              "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": 177.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 184.45
            },
            {
              "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": 217,
              "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": 137.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 120.44
            },
            {
              "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": 119.35
            },
            {
              "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": 217,
              "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": 217,
              "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": 184.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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,
              "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": 139.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 217,
              "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": 217,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 184.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 139.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 177.94
            },
            {
              "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": 139.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 217,
              "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": 217,
              "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": 141.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 217
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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,
              "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": 217,
              "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": 184.45
            },
            {
              "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": 184.45
            },
            {
              "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": 217,
              "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": 184.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 184.45
            },
            {
              "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": 217,
              "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": 177.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 177.94
            },
            {
              "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": 190.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 179.89
            },
            {
              "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": 190.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.41
            },
            {
              "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": 217,
              "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": 175.55
            },
            {
              "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": 177.94
            },
            {
              "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": 217,
              "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": 119.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 139.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 139.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 217,
              "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": 158.41
            },
            {
              "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": 217,
              "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": 139.31
            },
            {
              "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": 177.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 162.75
            },
            {
              "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": 137.14
            },
            {
              "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": 217,
              "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": 217,
              "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": 184.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 184.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.35
            },
            {
              "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": 217,
              "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": 137.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 120.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 179.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 137.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 119.35
            },
            {
              "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": 120.44
            },
            {
              "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": 158.41
            },
            {
              "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": 120.44
            },
            {
              "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": 217,
              "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": 139.31
            },
            {
              "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": 217,
              "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": 184.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 137.14
            },
            {
              "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": 217,
              "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": 217,
              "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": 141.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 217,
              "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": 217,
              "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": 119.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 217,
              "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": 217,
              "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": 184.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 184.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 139.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 177.94
            },
            {
              "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": 59.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 137.14
            },
            {
              "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": 141.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 139.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 177.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.41
            },
            {
              "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": 190.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 139.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 175.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 162.75
            },
            {
              "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": 139.31
            },
            {
              "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": 179.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 137.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 141.27
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ldh So",
      "code_information": [
        {
          "code": "PX-30101042",
          "type": "CDM"
        },
        {
          "code": "83615",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 25,
          "discounted_cash": 16.25,
          "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": 16.05
            },
            {
              "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": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.04,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "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": 20.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "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": 20.5
            },
            {
              "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": 13.88
            },
            {
              "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": 25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.04,
              "estimated_amount": 6.04
            },
            {
              "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": 16.28
            },
            {
              "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": 20.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.1,
              "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": 13.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "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": 16.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "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": 13.88
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "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": 16.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "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": 18.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.1,
              "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": 13.88
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.04,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 16.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.04,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.1,
              "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": 18.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "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": 20.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "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": 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": 15.8
            },
            {
              "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": 15.8
            },
            {
              "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": 21.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.04,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.34,
              "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": 16.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "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": 15.8
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "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": 20.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.5
            },
            {
              "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": 6.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.04,
              "estimated_amount": 6.04
            },
            {
              "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": 16.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "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": 21.93
            },
            {
              "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": 16.05
            },
            {
              "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": 21.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.04,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.1,
              "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": 25,
              "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": 20.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.28
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 6.04,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 6.34,
              "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": 20.5
            },
            {
              "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": 21.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.65,
              "estimated_amount": 22.65
            },
            {
              "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": 22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.25
            },
            {
              "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": 16.05
            },
            {
              "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": 16.28
            },
            {
              "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": 13.75
            },
            {
              "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": 25,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 6.04,
          "maximum": 22.65
        }
      ]
    },
    {
      "description": "HC Somatomedin So",
      "code_information": [
        {
          "code": "PX-30101055",
          "type": "CDM"
        },
        {
          "code": "84305",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 47,
          "discounted_cash": 30.55,
          "minimum": 18.24,
          "maximum": 79.73,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.26,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.07,
              "estimated_amount": 31.07
            },
            {
              "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": 39.95
            },
            {
              "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": 39.95
            },
            {
              "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": 38.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.32,
              "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": 39.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.26,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 21.15
            },
            {
              "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": 47,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.24,
              "estimated_amount": 18.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.24,
              "estimated_amount": 18.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.26,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.54
            },
            {
              "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": 23.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.26,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.26,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 21.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "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": 38.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.24,
              "estimated_amount": 18.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "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": 25.85
            },
            {
              "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": 34.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.24,
              "estimated_amount": 18.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 21.15
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.07,
              "estimated_amount": 31.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "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": 23.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 21.15
            },
            {
              "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": 47,
              "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": 39.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "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": 11.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.26,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.31
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "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": 38.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 21.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.26,
              "estimated_amount": 21.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "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": 47,
              "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": 34.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 22.32,
              "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": 35.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "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": 30.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.07,
              "estimated_amount": 31.07
            },
            {
              "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": 21.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 21.26,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.47,
              "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": 45,
              "estimated_amount": 21.15
            },
            {
              "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": 21.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.54
            },
            {
              "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": 21.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.23,
              "estimated_amount": 39.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 21.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.95
            },
            {
              "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": 41.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 79.73,
              "estimated_amount": 79.73
            }
          ]
        }
      ]
    },
    {
      "description": "HC Protozoa Antibody Nes So",
      "code_information": [
        {
          "code": "PX-30200604",
          "type": "CDM"
        },
        {
          "code": "86753",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 132,
          "discounted_cash": 85.8,
          "minimum": 10.63,
          "maximum": 46.46,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "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": 72.6
            },
            {
              "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": 116.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.01,
              "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": 112.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.64,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.63,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.64,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "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": 112.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.63,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.63,
              "estimated_amount": 10.63
            },
            {
              "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": 108.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.36
            },
            {
              "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": 112.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.64,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.08,
              "estimated_amount": 16.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "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": 96.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.63,
              "estimated_amount": 10.63
            },
            {
              "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": 85.8
            },
            {
              "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": 108.24
            },
            {
              "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": 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": 96.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 132
            },
            {
              "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": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.56,
              "estimated_amount": 14.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "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": 108.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.56,
              "estimated_amount": 14.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 12.39,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 12.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.39,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "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": 132,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.46,
              "estimated_amount": 46.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.32,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.2
            }
          ]
        }
      ]
    },
    {
      "description": "HH Msw Visit",
      "code_information": [
        {
          "code": "PX-56100100",
          "type": "CDM"
        },
        {
          "code": "G0155",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 88.64,
          "discounted_cash": 57.62,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 75.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 88.64,
              "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": 71.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 56.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.91
            },
            {
              "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": 71.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 73.48
            },
            {
              "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": 56.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.02
            },
            {
              "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": 48.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 66.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.71
            },
            {
              "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": 75.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 77.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "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": 49.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 88.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 88.64,
              "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": 56.91
            },
            {
              "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": 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": 72.68
            },
            {
              "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": 24.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.68
            },
            {
              "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": 56.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "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": 64.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 73.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 48.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.71
            },
            {
              "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": 56.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.68
            },
            {
              "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": 78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 72.68
            },
            {
              "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": 75.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.71
            },
            {
              "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": 56.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 48.75
            },
            {
              "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": 56.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 72.68
            },
            {
              "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": 77.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 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": 75.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 73.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.71
            },
            {
              "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": 56.91
            },
            {
              "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": 72.68
            },
            {
              "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": 49.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "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": 49.2
            },
            {
              "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": 88.64,
              "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": 57.7
            },
            {
              "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": 56.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 88.64,
              "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": 57.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 56.02
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 74.25,
          "discounted_cash": 57.62,
          "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": 74.25,
              "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": 74.25,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Continuous Care per Diem",
      "code_information": [
        {
          "code": "PX-65200100",
          "type": "CDM"
        },
        {
          "code": "65200100",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 90.47,
          "discounted_cash": 58.81,
          "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": 58.08
            },
            {
              "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": 58.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.19
            },
            {
              "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": 58.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.85
            },
            {
              "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": 58.08
            },
            {
              "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": 50.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "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": 58.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 73.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "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": 24.7
            },
            {
              "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": 79.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "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": 50.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "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": 74.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.18
            },
            {
              "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": 76.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.47,
              "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": 56.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.04
            },
            {
              "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": 76.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "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": 58.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.47,
              "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": 58.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 50.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 58.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.9
            },
            {
              "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": 56.82
            },
            {
              "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": 56.82
            },
            {
              "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": 57.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.08
            },
            {
              "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": 49.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 66.04
            },
            {
              "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": 90.47,
              "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": 58.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 58.72
            },
            {
              "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": 58.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.18
            },
            {
              "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": 57.18
            },
            {
              "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": 90.47,
              "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": 57.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.9
            },
            {
              "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": 74.19
            },
            {
              "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": 79.61
            },
            {
              "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": 90.47,
              "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": 62.8,
              "estimated_amount": 56.82
            },
            {
              "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": 79.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.85
            },
            {
              "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": 58.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 58.72
            },
            {
              "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": 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": 74.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 90.47
            },
            {
              "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": 50.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 56.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 58.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.9
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Inpatient Respite Care per Diem",
      "code_information": [
        {
          "code": "PX-65500100",
          "type": "CDM"
        },
        {
          "code": "65500100",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 700.22,
          "discounted_cash": 455.14,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 574.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 385.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "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": 442.54
            },
            {
              "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": 700.22,
              "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": 566.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 511.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 700.22,
              "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": 455.84
            },
            {
              "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": 574.18
            },
            {
              "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": 614.09
            },
            {
              "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": 595.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 511.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 525.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 525.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 511.16
            },
            {
              "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": 449.54
            },
            {
              "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": 574.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 385.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "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": 439.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "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": 580.48
            },
            {
              "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": 700.22,
              "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": 595.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 511.16
            },
            {
              "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": 616.19
            },
            {
              "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": 511.16
            },
            {
              "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": 388.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 700.22
            },
            {
              "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": 595.19
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "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": 449.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 574.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 511.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "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": 191.16
            },
            {
              "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": 385.12
            },
            {
              "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": 700.22,
              "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": 449.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.44
            },
            {
              "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": 449.54
            },
            {
              "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": 574.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 574.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 385.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 580.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 385.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.54
            },
            {
              "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": 449.54
            },
            {
              "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": 566.48
            },
            {
              "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": 388.62
            },
            {
              "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": 614.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 574.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 388.62
            },
            {
              "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": 439.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 580.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.54
            },
            {
              "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": 388.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.74
            },
            {
              "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": 442.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.54
            },
            {
              "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": 442.54
            },
            {
              "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": 700.22,
              "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": 449.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 385.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 385.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 595.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 525.17
            },
            {
              "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": 439.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.54
            },
            {
              "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": 455.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 574.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.44
            },
            {
              "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": 455.14
            }
          ]
        }
      ]
    },
    {
      "description": "Cryoablation Bone Tumor W Img",
      "code_information": [
        {
          "code": "PX-36100776",
          "type": "CDM"
        },
        {
          "code": "20983",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12095,
          "discounted_cash": 7861.75,
          "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": 7764.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 12095
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8829.35
            },
            {
              "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": 6306.4,
              "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": 12095,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 12095
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 10280.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2177.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7644.04
            },
            {
              "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": 3301.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9071.25
            },
            {
              "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": 12095,
              "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": 10026.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7764.99
            },
            {
              "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": 9917.9
            },
            {
              "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": 10607.32
            },
            {
              "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": 8829.35
            },
            {
              "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": 6243.96,
              "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": 7764.99
            },
            {
              "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": 7861.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 9917.9
            },
            {
              "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": 7764.99
            },
            {
              "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": 10607.32
            },
            {
              "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": 6556.16,
              "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": 7764.99
            },
            {
              "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": 12095,
              "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": 8829.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 12095
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9917.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8829.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7644.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7644.04
            },
            {
              "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": 6306.4,
              "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": 12095,
              "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": 2648.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9071.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 12095
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9784.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8829.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7873.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 10280.75
            },
            {
              "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": 10643.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 12095,
              "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": 12095,
              "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": 12095,
              "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": 10280.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6652.25
            },
            {
              "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": 6243.96,
              "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": 6243.96,
              "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": 7764.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 12095
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7644.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "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": 6556.16,
              "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": 6652.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 7764.99
            },
            {
              "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": 7873.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7873.85
            },
            {
              "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": 9917.9
            },
            {
              "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": 7644.04
            },
            {
              "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": 7644.04
            },
            {
              "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": 6371.39,
              "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": 7764.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9784.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8829.35
            },
            {
              "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": 6306.4,
              "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": 12095,
              "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": 9917.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7644.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 12095,
              "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": 12095,
              "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": 6652.25
            },
            {
              "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": 10280.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7873.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9917.9
            },
            {
              "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": 7873.85
            },
            {
              "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": 6243.96,
              "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": 6652.25
            },
            {
              "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": 10026.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "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": 2177.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7764.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6652.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 10280.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 12095,
              "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": 10026.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7644.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6371.39,
              "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": 7764.99
            },
            {
              "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": 6556.16,
              "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": 6306.4,
              "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": 7764.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9917.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6652.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6652.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9071.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12095,
              "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": 10280.75
            },
            {
              "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": 9917.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "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": 6306.4,
              "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": 7764.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10280.75
            },
            {
              "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": 6371.39,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Alkoloids Nos So",
      "code_information": [
        {
          "code": "PX-30101070",
          "type": "CDM"
        },
        {
          "code": "80323",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 495,
          "discounted_cash": 321.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "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": "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 317.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 495,
              "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": 317.79
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "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": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 312.84
            },
            {
              "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": "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": "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": "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": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 495,
              "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": 420.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "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": 410.36
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 272.25
            },
            {
              "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": 322.25
            },
            {
              "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": 434.12
            },
            {
              "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": 434.12
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "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": 272.25
            },
            {
              "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 495,
              "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": 317.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "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": 317.79
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 495,
              "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": 361.35
            },
            {
              "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": "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": "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 UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 317.79
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "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": 495,
              "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": 420.75
            },
            {
              "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": 312.84
            },
            {
              "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": 495,
              "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": 420.75
            },
            {
              "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": "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 STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 400.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 312.84
            },
            {
              "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": 321.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 361.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 405.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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": "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": "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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.04,
              "estimated_amount": 12.04
            },
            {
              "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": 405.9
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 495,
              "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": 495,
              "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": 400.46
            }
          ],
          "minimum": 12.04,
          "maximum": 12.04
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Arbors Delaware",
      "code_information": [
        {
          "code": "PX-65900103",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 269.44,
          "discounted_cash": 175.14,
          "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": 172.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.41
            },
            {
              "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": 223.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 220.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 229.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 172.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 220.94
            },
            {
              "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": 149.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 172.98
            },
            {
              "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": 237.11
            },
            {
              "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": 229.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 269.44,
              "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": 148.19
            },
            {
              "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": 220.94
            },
            {
              "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": 170.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "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": 236.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 172.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.08
            },
            {
              "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": 170.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 172.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 202.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 196.69
            },
            {
              "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": 172.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 269.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 170.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "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": 73.56
            },
            {
              "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": 217.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 220.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.19
            },
            {
              "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": 269.44,
              "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": 170.29
            },
            {
              "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": 236.3
            },
            {
              "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": 172.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 220.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 217.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 196.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 172.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 172.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.41
            },
            {
              "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": 149.54
            },
            {
              "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": 229.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 269.44,
              "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": 172.98
            },
            {
              "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": 149.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 223.37
            },
            {
              "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": 172.98
            },
            {
              "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": 148.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 196.69
            },
            {
              "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": 269.44,
              "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": 175.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 149.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 223.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 196.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 196.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.29
            },
            {
              "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": 172.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 170.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 269.44,
              "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": 175.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "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": 269.44,
              "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": 269.44,
              "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": 220.94
            },
            {
              "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": 220.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.19
            },
            {
              "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": 196.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 220.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 269.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Embassy of Woodview",
      "code_information": [
        {
          "code": "PX-65900116",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 278.09,
          "discounted_cash": 180.76,
          "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": 178.53
            },
            {
              "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": 181.04
            },
            {
              "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": 228.03
            },
            {
              "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": 243.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 230.54
            },
            {
              "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": 236.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 208.57
            },
            {
              "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": 175.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 178.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 230.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 278.09,
              "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": 203.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 278.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 278.09,
              "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": 175.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 175.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.03
            },
            {
              "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": 228.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 178.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.53
            },
            {
              "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": 178.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 278.09,
              "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": 278.09,
              "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": 152.95
            },
            {
              "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": 236.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 178.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 230.54
            },
            {
              "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": 175.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.75
            },
            {
              "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": 154.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 181.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 175.75
            },
            {
              "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": 244.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.53
            },
            {
              "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": 75.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.95
            },
            {
              "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": 154.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 208.57
            },
            {
              "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": 154.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 154.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 224.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.01
            },
            {
              "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": 278.09,
              "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": 178.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 208.57
            },
            {
              "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": 203.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 181.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 181.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 224.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 178.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "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": 175.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 278.09,
              "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": 152.95
            },
            {
              "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": 243.88
            },
            {
              "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": 178.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 236.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 178.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 181.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 228.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 203.01
            },
            {
              "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": 228.03
            },
            {
              "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": 152.95
            },
            {
              "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": 278.09,
              "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": 236.38
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Liberty Mansfield",
      "code_information": [
        {
          "code": "PX-65900165",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 254.3,
          "discounted_cash": 165.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 163.26
            },
            {
              "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": 163.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 163.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 254.3,
              "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": 160.72
            },
            {
              "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": 163.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 165.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 160.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 163.26
            },
            {
              "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": 163.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 254.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 216.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 208.53
            },
            {
              "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": 141.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 254.3,
              "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": 254.3,
              "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": 139.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 165.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 141.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 185.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 254.3,
              "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": 254.3,
              "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": 165.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 210.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 163.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.87
            },
            {
              "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": 205.73
            },
            {
              "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": 160.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 185.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 190.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 208.53
            },
            {
              "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": 208.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 185.64
            },
            {
              "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": 160.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 160.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 208.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 139.87
            },
            {
              "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": 141.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 163.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 254.3,
              "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": 69.42
            },
            {
              "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": 141.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "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": 208.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 208.53
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 185.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 160.72
            },
            {
              "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": 163.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 163.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 185.64
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "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": 139.87
            },
            {
              "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": 216.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 205.73
            },
            {
              "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": 160.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 163.26
            },
            {
              "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": 223.78
            },
            {
              "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": 185.64
            },
            {
              "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": 163.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 160.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 216.16
            },
            {
              "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": 216.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 254.3
            },
            {
              "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": 165.55
            },
            {
              "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": 210.81
            },
            {
              "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": 223.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 210.81
            },
            {
              "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": 165.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 208.53
            },
            {
              "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": 208.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 254.3,
              "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": 223.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 190.73
            }
          ]
        }
      ]
    },
    {
      "description": "Hspc Room and Bed Legacy Marion",
      "code_information": [
        {
          "code": "PX-65900173",
          "type": "CDM"
        },
        {
          "code": "T2046",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 267.16,
          "discounted_cash": 173.65,
          "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": 171.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "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": 234.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 267.16,
              "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": 227.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 146.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 171.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 173.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 267.16,
              "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": 221.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 195.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 219.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 216.13
            },
            {
              "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": 234.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 171.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 195.03
            },
            {
              "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": 168.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 168.85
            },
            {
              "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": 173.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 200.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 146.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 173.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 146.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 195.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 171.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "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": 216.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 146.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 221.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 171.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 173.92
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 267.16,
              "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": 168.85
            },
            {
              "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": 146.94
            },
            {
              "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": 168.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 171.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 219.07
            },
            {
              "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": 219.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 171.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 219.07
            },
            {
              "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": 72.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 148.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 195.03
            },
            {
              "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": 227.09
            },
            {
              "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": 219.07
            },
            {
              "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": 171.52
            },
            {
              "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": 168.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 148.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 267.16,
              "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": 219.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 267.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 146.94
            },
            {
              "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": 195.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 168.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "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": 171.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 219.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 168.85
            },
            {
              "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": 235.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 200.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 146.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 267.16,
              "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": 219.07
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 227.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 171.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 171.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 227.09
            },
            {
              "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": 148.27
            },
            {
              "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": 221.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 195.03
            },
            {
              "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": 171.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 168.85
            },
            {
              "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": 148.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 267.16,
              "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": 267.16,
              "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": 200.37
            },
            {
              "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": 173.92
            }
          ]
        }
      ]
    },
    {
      "description": "Irrigation Tray W-60 Cc Piston Syringe",
      "code_information": [
        {
          "code": "PX-CHA1PIT",
          "type": "CDM"
        },
        {
          "code": "A4320",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.16,
          "discounted_cash": 0.75,
          "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": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.73
            },
            {
              "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": 0.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 1.16,
              "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": 1.16,
              "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": 0.95
            },
            {
              "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": 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": 0.85
            },
            {
              "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": 1.16,
              "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": 0.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "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": 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": 1.16,
              "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": 1.16,
              "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": 0.74
            },
            {
              "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": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "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": 1.16,
              "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": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 1.16,
              "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": 0.95
            },
            {
              "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": 0.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.87
            },
            {
              "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": 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": 0.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.74
            },
            {
              "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": 0.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.16,
              "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": 1.16,
              "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": 0.99
            },
            {
              "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": 1.16,
              "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": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.64
            },
            {
              "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": 0.64
            },
            {
              "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": 1.16,
              "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": 0.64
            },
            {
              "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": 1.16,
              "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": 1.16,
              "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": 1.16,
              "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": 0.74
            },
            {
              "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": 1.16,
              "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": 0.99
            },
            {
              "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": 1.16,
              "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": 1.16,
              "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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 1.16,
              "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": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 1.16,
              "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": 0.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 1.16,
              "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": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.73
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "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": 0.74
            },
            {
              "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": 1.16,
              "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": 0.74
            },
            {
              "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": 1.16,
              "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": 0.85
            },
            {
              "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": 1.16,
              "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": 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": 0.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 0.99
            },
            {
              "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": 1.16,
              "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": 0.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 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": 0.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.02
            },
            {
              "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": 1.16,
              "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": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.74
            },
            {
              "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": 0.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.16,
              "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": 1.16,
              "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": 1.16,
              "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": 0.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.16,
              "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": 0.76
            }
          ]
        }
      ]
    },
    {
      "description": "Tubular Drsg Tubigrip Size G Lrg Thighs 1 Each = 10 Yds",
      "code_information": [
        {
          "code": "PX-CHSC1453",
          "type": "CDM"
        },
        {
          "code": "A6457",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 112.09,
          "discounted_cash": 72.86,
          "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": 71.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.09,
              "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": 95.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.91
            },
            {
              "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": 62.21
            },
            {
              "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": 70.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.65
            },
            {
              "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": 81.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.83
            },
            {
              "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": 112.09,
              "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": 112.09,
              "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": 92.92
            },
            {
              "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": 98.3
            },
            {
              "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": 72.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 84.07
            },
            {
              "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": 70.84
            },
            {
              "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": 112.09,
              "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": 84.07
            },
            {
              "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": 112.09,
              "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": 70.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 112.09,
              "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": 112.09,
              "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": 95.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 112.09,
              "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": 71.96
            },
            {
              "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": 95.28
            },
            {
              "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": 112.09,
              "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": 91.91
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.09,
              "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": 71.96
            },
            {
              "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": 92.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.96
            },
            {
              "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": 112.09,
              "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": 90.68
            },
            {
              "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": 91.91
            },
            {
              "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": 112.09,
              "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": 62.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 98.64
            },
            {
              "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": 72.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 61.65
            },
            {
              "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": 112.09,
              "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": 61.65
            },
            {
              "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": 71.96
            },
            {
              "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": 91.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 112.09,
              "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": 70.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 112.09,
              "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": 71.96
            },
            {
              "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": 71.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 112.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.97
            },
            {
              "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": 30.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 81.83
            },
            {
              "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": 112.09,
              "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": 71.96
            },
            {
              "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": 112.09,
              "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": 61.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 112.09,
              "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": 91.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.65
            },
            {
              "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": 112.09,
              "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": 112.09,
              "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": 84.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.96
            },
            {
              "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": 71.96
            },
            {
              "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": 62.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112.09,
              "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": 95.28
            },
            {
              "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": 112.09,
              "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": 72.97
            },
            {
              "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": 112.09,
              "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": 112.09,
              "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": 112.09,
              "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": 112.09,
              "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": 81.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.28
            },
            {
              "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": 98.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.65
            },
            {
              "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": 112.09,
              "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": 90.68
            },
            {
              "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": 112.09,
              "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": 112.09,
              "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": 95.28
            }
          ]
        }
      ]
    },
    {
      "description": "Cyp2d6 Full Gene Sequence Sendout",
      "code_information": [
        {
          "code": "PX-30401440",
          "type": "CDM"
        },
        {
          "code": "0071U",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3672,
          "discounted_cash": 2386.8,
          "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": 2357.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3011.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2019.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2320.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2680.56
            },
            {
              "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": 2320.7
            },
            {
              "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": 2357.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3044.09
            },
            {
              "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": 2357.42
            },
            {
              "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": 2390.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2390.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3672,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2320.7
            },
            {
              "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": 3121.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "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": 3220.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2019.6
            },
            {
              "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": 3220.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2357.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2357.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2754
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2320.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "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": 2037.96
            },
            {
              "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": 2019.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2357.42
            },
            {
              "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": 2357.42
            },
            {
              "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": 2357.42
            },
            {
              "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": 2037.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2019.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3044.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3011.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3672,
              "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": 2680.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2680.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2680.56
            },
            {
              "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": 2357.42
            },
            {
              "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": 3011.04
            },
            {
              "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": 1002.46
            },
            {
              "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": 3231.36
            },
            {
              "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": 3672,
              "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": 3672
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2320.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2754
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2037.96
            },
            {
              "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": 2037.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3044.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2357.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2357.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2019.6
            },
            {
              "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": 3121.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2970.65
            },
            {
              "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": 3011.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2390.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3121.2
            },
            {
              "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": 2386.8
            },
            {
              "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": 2970.65
            },
            {
              "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": 3011.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3011.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2390.47
            },
            {
              "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": 2390.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3011.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3011.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2320.7
            },
            {
              "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": 3672,
              "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": 2680.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2357.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2250,
              "estimated_amount": 2250
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3672,
              "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": 2320.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2019.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2019.6
            },
            {
              "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": 2680.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2320.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2754
            }
          ],
          "minimum": 2250,
          "maximum": 2250
        }
      ]
    },
    {
      "description": "HC Mopath Level 4 Arc",
      "code_information": [
        {
          "code": "PX-30401454",
          "type": "CDM"
        },
        {
          "code": "81403",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 642,
          "discounted_cash": 417.3,
          "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": 412.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 353.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "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": 417.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 526.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.2,
              "estimated_amount": 185.2
            },
            {
              "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": 356.31
            },
            {
              "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": 412.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 353.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 194.46,
              "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": 356.31
            },
            {
              "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": 417.94
            },
            {
              "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": 526.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 526.44
            },
            {
              "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": 563.03
            },
            {
              "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": 405.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 468.66
            },
            {
              "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": 545.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.2,
              "estimated_amount": 185.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 207.1,
              "estimated_amount": 207.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 194.46,
              "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": 545.7
            },
            {
              "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": 353.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 412.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 526.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 412.16
            },
            {
              "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": 412.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 526.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 532.22
            },
            {
              "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": 642,
              "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": 526.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 481.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 353.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 356.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.2,
              "estimated_amount": 185.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 481.5
            },
            {
              "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": 412.16
            },
            {
              "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": 412.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "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": 417.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 353.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 187.05,
              "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": 412.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.2,
              "estimated_amount": 185.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "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": 519.38
            },
            {
              "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": 532.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 353.1
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 207.1,
              "estimated_amount": 207.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 468.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 468.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 187.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 207.1,
              "estimated_amount": 207.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 412.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 532.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "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": 642,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 353.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "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": 468.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.2,
              "estimated_amount": 185.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.74
            },
            {
              "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": 545.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "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": 175.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 519.38
            },
            {
              "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": 356.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 468.66
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 194.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 187.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 187.05,
              "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": 642
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "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": 563.03
            },
            {
              "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": 405.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 468.66
            },
            {
              "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": 564.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 545.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 412.16
            },
            {
              "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": 412.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 412.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.2,
              "estimated_amount": 185.2
            },
            {
              "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": 526.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 481.5
            },
            {
              "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": 405.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 185.2,
              "estimated_amount": 185.2
            },
            {
              "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": 642,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 694.5,
              "estimated_amount": 694.5
            },
            {
              "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": 526.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 185.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 187.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 185.2,
          "maximum": 694.5
        }
      ]
    },
    {
      "description": "Saline Flush Sterile 0.9% 10 Ml",
      "code_information": [
        {
          "code": "PX-CHBD306500",
          "type": "CDM"
        },
        {
          "code": "A4216",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.17,
          "discounted_cash": 0.76,
          "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": 0.75
            },
            {
              "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": 1.17,
              "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": 0.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.17,
              "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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.75
            },
            {
              "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": 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": 0.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.75
            },
            {
              "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": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.76
            },
            {
              "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": 0.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.96
            },
            {
              "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": 1.17,
              "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": 1.17,
              "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": 1.17,
              "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": 0.99
            },
            {
              "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": 0.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.17,
              "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": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.03
            },
            {
              "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": 1.17,
              "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": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "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": 1.17,
              "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": 0.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "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": 0.97
            },
            {
              "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": 1.17,
              "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": 1.17,
              "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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 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": 1.17,
              "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": 1.17,
              "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": 1.17,
              "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": 0.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.17,
              "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": 0.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 0.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.64
            },
            {
              "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": 1.17,
              "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": 0.65
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.03
            },
            {
              "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": 1.03
            },
            {
              "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": 1.17,
              "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": 0.99
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 1.17,
              "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": 1.17,
              "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": 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": 0.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 0.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.17,
              "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": 0.99
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 1.17,
              "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": 0.74
            },
            {
              "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": 0.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 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": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.17,
              "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": 1.17,
              "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": 1.17,
              "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": 0.75
            },
            {
              "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": 1.17,
              "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": 0.64
            },
            {
              "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": 1.17,
              "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": 0.96
            },
            {
              "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": 0.74
            },
            {
              "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": 1.17,
              "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": 0.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.88
            },
            {
              "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": 1.17,
              "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": 0.64
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 0.98,
          "discounted_cash": 0.64,
          "payers_information": [
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "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": 0.98,
              "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": 0.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.98,
              "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": 0.63
            },
            {
              "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": 0.83
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.98,
              "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": 0.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.81
            },
            {
              "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": 0.63
            },
            {
              "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": 0.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 0.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "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": 0.98,
              "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": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.64
            },
            {
              "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": 0.79
            },
            {
              "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": 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": 0.98,
              "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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "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": 0.54
            },
            {
              "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": 0.63
            },
            {
              "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": 0.98,
              "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": 0.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.98,
              "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": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "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": 0.98,
              "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": 0.54
            },
            {
              "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": 0.98,
              "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": 0.98,
              "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": 0.98,
              "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": 0.98,
              "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": 0.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.54
            },
            {
              "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": 0.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "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": 0.98,
              "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": 0.54
            },
            {
              "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": 0.98,
              "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": 0.98,
              "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": 0.98,
              "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": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.54
            },
            {
              "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": 0.83
            },
            {
              "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": 0.27
            },
            {
              "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": 0.98,
              "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": 0.74
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.54
            },
            {
              "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": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.98,
              "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": 0.98,
              "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": 0.98,
              "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": 0.98,
              "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": 0.72
            },
            {
              "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": 0.98,
              "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": 0.63
            },
            {
              "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": 0.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.54
            },
            {
              "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": 0.63
            },
            {
              "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": 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": 0.72
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 2.13,
          "discounted_cash": 1.38,
          "payers_information": [
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "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": 1.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 1.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.35
            },
            {
              "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": 1.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.72
            },
            {
              "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": 1.18
            },
            {
              "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": 1.39
            },
            {
              "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": 1.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "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": 2.13,
              "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": 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": 1.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.37
            },
            {
              "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": 1.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.13,
              "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": 1.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 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": 1.77
            },
            {
              "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": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.13,
              "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": 2.13,
              "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": 2.13,
              "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": 2.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "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": 1.37
            },
            {
              "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": 2.13,
              "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": 1.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.6
            },
            {
              "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": 1.87
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "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": 1.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "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": 1.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.18
            },
            {
              "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": 1.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 1.81
            },
            {
              "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": 1.81
            },
            {
              "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": 2.13,
              "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": 1.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.39
            },
            {
              "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": 1.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "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": 1.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "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": 1.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "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": 2.13,
              "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": 1.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.13,
              "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": 1.18
            },
            {
              "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": 1.37
            },
            {
              "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": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.75
            },
            {
              "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": 1.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.35
            },
            {
              "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": 1.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 2.13,
              "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": 2.13,
              "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": 1.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "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": 1.18
            },
            {
              "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": 2.13,
              "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": 1.37
            },
            {
              "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": 1.87
            },
            {
              "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": 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": 2.13,
              "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": 1.35
            },
            {
              "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": 2.13,
              "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": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.17
            },
            {
              "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": 2.13,
              "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": 2.13,
              "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": 2.13,
              "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": 1.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 1.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Intermittent Catheter 14fr 6\"\" Female\"",
      "code_information": [
        {
          "code": "PX-CHCV501022",
          "type": "CDM"
        },
        {
          "code": "A4351",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.61,
          "discounted_cash": 0.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.39
            },
            {
              "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": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.52
            },
            {
              "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": 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": 0.39
            },
            {
              "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": 0.61,
              "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": 0.39
            },
            {
              "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": 0.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.45
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.51
            },
            {
              "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": 0.61,
              "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": 0.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.34
            },
            {
              "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": 0.52
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.51
            },
            {
              "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": 0.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.45
            },
            {
              "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": 0.61,
              "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": 0.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.34
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.4
            },
            {
              "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": 0.61,
              "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": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.39
            },
            {
              "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": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 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": 0.61,
              "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": 0.54
            },
            {
              "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": 0.39
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.52
            },
            {
              "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": 0.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.39
            },
            {
              "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": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.4
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            },
            {
              "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": 0.49
            },
            {
              "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": 0.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "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": 0.61,
              "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": 0.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.61,
              "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": 0.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.5
            },
            {
              "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": 0.52
            },
            {
              "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": 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": 0.5
            },
            {
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.61,
              "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": 0.52
            }
          ]
        }
      ]
    },
    {
      "description": "Vaccine Hpv - Grant Funded",
      "code_information": [
        {
          "code": "PX-63600081",
          "type": "CDM"
        },
        {
          "code": "90651",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 732,
          "discounted_cash": 475.8,
          "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": 469.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 592.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 534.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 534.36
            },
            {
              "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": 462.62
            },
            {
              "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": 644.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "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": 732,
              "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": 622.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "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": 475.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 534.36
            },
            {
              "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": 600.24
            },
            {
              "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": 402.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 476.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 469.94
            },
            {
              "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": 476.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 600.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 402.6
            },
            {
              "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": 469.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 462.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 672.84,
              "estimated_amount": 672.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "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": 622.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "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": 476.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "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": 641.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 534.36
            },
            {
              "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": 622.2
            },
            {
              "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": 462.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 462.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 469.94
            },
            {
              "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": 469.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 672.84,
              "estimated_amount": 672.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "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": 641.96
            },
            {
              "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": 732,
              "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": 622.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 672.84,
              "estimated_amount": 672.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 462.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 469.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 600.24
            },
            {
              "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": 199.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 672.84,
              "estimated_amount": 672.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 606.83
            },
            {
              "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": 600.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 600.24
            },
            {
              "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": 732,
              "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": 462.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 549
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 606.83
            },
            {
              "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": 592.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 476.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 549
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 672.84,
              "estimated_amount": 672.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "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": 606.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 462.62
            },
            {
              "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": 732,
              "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": 469.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 476.53
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 622.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 534.36
            },
            {
              "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": 534.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 732,
              "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": 402.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 549
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 469.94
            },
            {
              "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": 600.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 600.24
            },
            {
              "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": 469.94
            },
            {
              "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": 462.62
            },
            {
              "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": 469.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 469.94
            },
            {
              "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": 469.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 934.65,
              "estimated_amount": 934.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 600.24
            }
          ],
          "minimum": 672.84,
          "maximum": 934.65
        }
      ]
    },
    {
      "description": "Povidine Iodine Ointment 1 Oz",
      "code_information": [
        {
          "code": "PX-CHLI755826",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.19,
          "discounted_cash": 2.07,
          "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": 2.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 1.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.33
            },
            {
              "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": 2.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.02
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.08
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 3.19,
              "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": 2.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "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": 2.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "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": 3.19,
              "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": 2.71
            },
            {
              "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": 2.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.33
            },
            {
              "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": 2.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 2.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 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": 2.02
            },
            {
              "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": 1.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.33
            },
            {
              "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": 2.02
            },
            {
              "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": 2.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.75
            },
            {
              "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": 2.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.75
            },
            {
              "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": 3.19,
              "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": 3.19,
              "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": 2.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "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": 2.08
            },
            {
              "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": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.19,
              "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": 2.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "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": 2.71
            },
            {
              "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": 2.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 2.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.71
            },
            {
              "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": 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": 2.02
            },
            {
              "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": 3.19,
              "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": 3.19,
              "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": 3.19,
              "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": 1.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.19,
              "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": 2.02
            },
            {
              "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": 3.19,
              "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": 2.62
            },
            {
              "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": 2.05
            },
            {
              "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.19,
              "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": 3.19,
              "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": 2.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 2.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.19,
              "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": 1.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.75
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.58
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Wipe No-Sting Skin-Prep",
      "code_information": [
        {
          "code": "PX-CHUN59420600",
          "type": "CDM"
        },
        {
          "code": "A5120",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.9,
          "discounted_cash": 0.58,
          "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": 0.58
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "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": 0.9,
              "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": 0.9,
              "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 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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.68
            },
            {
              "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": 0.58
            },
            {
              "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": 0.74
            },
            {
              "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": 0.25
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": "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 OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "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": 0.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "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": 0.66
            },
            {
              "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": 0.9,
              "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": 0.9,
              "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": 0.9,
              "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": 0.77
            },
            {
              "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 SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 0.57
            },
            {
              "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": 0.9,
              "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": 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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "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": 0.9,
              "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": 0.66
            },
            {
              "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": 0.9,
              "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": 0.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC 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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "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": 0.9,
              "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": 0.66
            },
            {
              "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": 0.9,
              "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": 0.58
            },
            {
              "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": "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": "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "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": "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "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": 0.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "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 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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "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": "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": "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": "BUCKEYE COMMUNITY 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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.9,
              "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": 0.9,
              "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": 0.75
            },
            {
              "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": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.5
            },
            {
              "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": "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": "AETNA [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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "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": 0.5
            },
            {
              "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": 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": "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": "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": "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": "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": "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            }
          ]
        }
      ]
    },
    {
      "description": "Heart Valve 36",
      "code_information": [
        {
          "code": "PX-27800235",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41256,
          "discounted_cash": 26816.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26445.1
            },
            {
              "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": 26816.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 41256
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26445.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26857.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22690.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22690.8
            },
            {
              "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": 26445.1
            },
            {
              "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": 26445.1
            },
            {
              "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": 26445.1
            },
            {
              "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": 35067.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26362.58
            },
            {
              "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": 26445.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26445.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33829.92
            },
            {
              "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": 26857.66
            },
            {
              "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": 33829.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33829.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22690.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22690.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "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": 25166.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41256,
              "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": 25166.16
            },
            {
              "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": 34201.22
            },
            {
              "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": 41256,
              "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": 26445.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30116.88
            },
            {
              "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": 41256,
              "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": 27022.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "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": 33829.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30116.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22897.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "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": 26857.66
            },
            {
              "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": 26445.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30942
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30942
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 27022.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26445.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33829.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30942
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41256,
              "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": 35067.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33376.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "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": 36305.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26857.66
            },
            {
              "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": 11262.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22690.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30116.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 27022.68
            },
            {
              "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": 22897.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26362.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 27022.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26445.1
            },
            {
              "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": 22690.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22690.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 27022.68
            },
            {
              "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": 22897.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26362.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30116.88
            },
            {
              "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": 41256,
              "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": 36181.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 27022.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33829.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34201.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26445.1
            },
            {
              "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": 33376.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33829.92
            },
            {
              "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": 22897.08
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35067.6
            },
            {
              "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": 33829.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "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": 30116.88
            },
            {
              "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": 36181.51
            },
            {
              "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": 35067.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30116.88
            },
            {
              "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": 27022.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 25166.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26362.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34201.22
            },
            {
              "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": 27022.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26857.66
            }
          ]
        }
      ]
    },
    {
      "description": "\"Foam Drsg Adhesive Border Kerrafoam 4\"\" X12\"\"\"",
      "code_information": [
        {
          "code": "PX-CH87CWL1134",
          "type": "CDM"
        },
        {
          "code": "A6213",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.02,
          "discounted_cash": 7.81,
          "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": 7.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.02
            },
            {
              "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": 12.02,
              "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": 12.02,
              "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": 7.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.83
            },
            {
              "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": 9.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 7.6
            },
            {
              "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": 10.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 7.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.72
            },
            {
              "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": 7.72
            },
            {
              "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": 7.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 8.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 10.22
            },
            {
              "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": 9.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 7.72
            },
            {
              "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": 7.72
            },
            {
              "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": 9.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.67
            },
            {
              "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": 9.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.6
            },
            {
              "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": 12.02,
              "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": 12.02,
              "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": 12.02,
              "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": 8.77
            },
            {
              "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": 12.02,
              "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": 10.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.02
            },
            {
              "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": 7.6
            },
            {
              "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": 12.02,
              "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": 12.02,
              "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": 12.02,
              "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": 7.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.02,
              "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": 12.02,
              "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": 12.02,
              "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": 12.02,
              "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": 10.22
            },
            {
              "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": 12.02,
              "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": 12.02,
              "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": 6.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.61
            },
            {
              "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": 12.02,
              "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": 12.02,
              "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": 64.2,
              "estimated_amount": 7.72
            },
            {
              "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": 12.02,
              "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": 63.2,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.86
            },
            {
              "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": 7.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.61
            },
            {
              "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": 12.02,
              "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": 6.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 12.02,
              "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": 9.86
            },
            {
              "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": 9.86
            },
            {
              "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": 12.02,
              "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": 7.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 12.02,
              "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": 7.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.86
            },
            {
              "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": 6.67
            },
            {
              "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": 12.02,
              "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": 7.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.22
            },
            {
              "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": 8.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 7.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.86
            },
            {
              "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": 6.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.77
            },
            {
              "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": 3.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 7.6
            },
            {
              "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": 12.02,
              "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": 12.02,
              "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": 9.96
            },
            {
              "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": 6.61
            },
            {
              "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": 10.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 12.02,
              "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": 12.02,
              "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": 7.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 10.54
            },
            {
              "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": 12.02,
              "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": 10.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.02,
              "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": 9.02
            }
          ]
        }
      ]
    },
    {
      "description": "Matrix Drsg Collagen 4 in X 4 in Colactive",
      "code_information": [
        {
          "code": "PX-CHHA10180000",
          "type": "CDM"
        },
        {
          "code": "A6022",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.4,
          "discounted_cash": 10.66,
          "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": 10.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 13.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 10.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.3
            },
            {
              "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": 10.53
            },
            {
              "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": 10.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.3
            },
            {
              "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": 10.53
            },
            {
              "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": 16.4,
              "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": 16.4,
              "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": 16.4,
              "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": 9.02
            },
            {
              "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": 11.97
            },
            {
              "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": 16.4,
              "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": 16.4,
              "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": 10.36
            },
            {
              "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": 16.4,
              "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": 14.38
            },
            {
              "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": 13.94
            },
            {
              "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": 14.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.02
            },
            {
              "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": 16.4,
              "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": 10.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.45
            },
            {
              "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": 10.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.45
            },
            {
              "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": 16.4,
              "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": 13.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.02
            },
            {
              "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": 13.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 16.4,
              "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": 10.36
            },
            {
              "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": 10.68
            },
            {
              "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": 16.4,
              "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": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 9.1
            },
            {
              "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": 13.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.36
            },
            {
              "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": 16.4,
              "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": 16.4,
              "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": 10.68
            },
            {
              "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": 16.4,
              "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": 16.4,
              "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": 16.4,
              "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": 10.36
            },
            {
              "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": 16.4,
              "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": 4.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.53
            },
            {
              "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": 10.53
            },
            {
              "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": 9.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 16.4,
              "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": 16.4,
              "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": 16.4,
              "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": 13.94
            },
            {
              "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": 13.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.97
            },
            {
              "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": 16.4,
              "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": 16.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 13.45
            },
            {
              "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": 10.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.53
            },
            {
              "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": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 14.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.68
            },
            {
              "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": 16.4,
              "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": 10.53
            },
            {
              "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": 9.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.4,
              "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": 11.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.94
            },
            {
              "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": 16.4,
              "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": 13.94
            },
            {
              "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": 16.4,
              "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": 11.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 16.4,
              "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": 13.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.94
            },
            {
              "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": 9.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 10.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "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": 13.6
            },
            {
              "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": 16.4,
              "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": 13.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Toothette Suction Oral Swab Single Use System",
      "code_information": [
        {
          "code": "PX-CHBUR6512",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.56,
          "discounted_cash": 1.66,
          "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": 1.64
            },
            {
              "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": 2.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.56
            },
            {
              "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": 2.56,
              "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": 2.56,
              "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": 2.56,
              "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": 1.87
            },
            {
              "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": 1.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.56,
              "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": 1.42
            },
            {
              "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": 2.56,
              "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": 1.92
            },
            {
              "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": 2.56,
              "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": 2.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.1
            },
            {
              "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": 2.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 2.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.56,
              "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": 1.87
            },
            {
              "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": 2.56,
              "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": 1.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.62
            },
            {
              "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": 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": 1.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "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": 2.56,
              "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": 2.18
            },
            {
              "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": 1.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.12
            },
            {
              "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": 2.56,
              "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": 1.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.64
            },
            {
              "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": 1.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 2.56,
              "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": 1.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 1.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.1
            },
            {
              "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": 2.1
            },
            {
              "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": 1.62
            },
            {
              "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": 2.56,
              "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": 2.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.64
            },
            {
              "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": 2.18
            },
            {
              "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": 2.56,
              "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": 2.07
            },
            {
              "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": 2.56,
              "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": 1.64
            },
            {
              "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": 1.67
            },
            {
              "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": 0.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 2.56,
              "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": 1.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.87
            },
            {
              "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": 2.56,
              "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": 1.42
            },
            {
              "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": 1.64
            },
            {
              "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": 2.56,
              "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": 2.56,
              "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": 2.18
            },
            {
              "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": 2.56,
              "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": 1.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "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": 1.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 2.56,
              "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": 2.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 2.56,
              "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": 1.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 2.56,
              "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": 2.1
            },
            {
              "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": 1.62
            },
            {
              "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": 2.25
            },
            {
              "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": 2.56,
              "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": 2.56,
              "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": 1.92
            },
            {
              "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": 2.56,
              "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": 64.2,
              "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": 1.67
            },
            {
              "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": 1.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 1.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.56,
              "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": 2.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.41
            },
            {
              "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": 2.56,
              "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": 1.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Pre-Cut Urostomy Mio Sesura",
      "code_information": [
        {
          "code": "PX-CHCO16841",
          "type": "CDM"
        },
        {
          "code": "A4392",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.21,
          "discounted_cash": 7.29,
          "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": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.18
            },
            {
              "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": 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": 11.21,
              "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": 11.21,
              "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": 11.21,
              "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": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 11.21,
              "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": 6.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.19
            },
            {
              "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": 3.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 7.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 9.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.53
            },
            {
              "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": 11.21,
              "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": 11.21,
              "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": 7.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.2
            },
            {
              "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": 7.3
            },
            {
              "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": 9.07
            },
            {
              "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": 7.08
            },
            {
              "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": 6.22
            },
            {
              "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": 6.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.2
            },
            {
              "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": 7.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 11.21,
              "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": 9.19
            },
            {
              "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": 6.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 9.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.41
            },
            {
              "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": 9.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.41
            },
            {
              "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": 9.53
            },
            {
              "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": 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": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 9.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 9.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 9.29
            },
            {
              "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": 7.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.3
            },
            {
              "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": 9.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.53
            },
            {
              "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": 9.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 11.21,
              "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": 9.53
            },
            {
              "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": 9.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.17
            },
            {
              "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": 11.21,
              "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": 8.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 11.21,
              "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": 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": 8.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "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": 11.21,
              "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": 9.53
            },
            {
              "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": 8.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.08
            },
            {
              "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": 11.21,
              "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": 11.21,
              "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": 6.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Toothette Unflavored Thick 24\"\" L 3-8\"\" Thick Bircwood\"",
      "code_information": [
        {
          "code": "PX-CHTO5602UT",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.24,
          "discounted_cash": 0.16,
          "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": 0.15
            },
            {
              "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": 0.15
            },
            {
              "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": 0.2
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "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 MYCARE 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": "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN 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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC 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"
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "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": 0.18
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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 MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "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 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": "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": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "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": 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": 0.18
            },
            {
              "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": "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": "AETNA [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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.13
            },
            {
              "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.18
            },
            {
              "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": 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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.16
            },
            {
              "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "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": 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": 0.21
            },
            {
              "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 OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "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": 0.24,
              "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": 0.2
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA 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": "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.19
            },
            {
              "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": 0.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "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": 0.24,
              "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": 0.24,
              "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": 0.24,
              "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": 0.15
            },
            {
              "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": 0.24,
              "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": 0.13
            },
            {
              "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": 0.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.24,
              "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": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "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": 0.18
            },
            {
              "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": 0.21
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.16
            },
            {
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "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 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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "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": 0.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch Sensura Red Click",
      "code_information": [
        {
          "code": "PX-CHCO11125",
          "type": "CDM"
        },
        {
          "code": "A4427",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.74,
          "discounted_cash": 2.43,
          "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": 2.4
            },
            {
              "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": 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": 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": 2.73
            },
            {
              "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": 2.36
            },
            {
              "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": 2.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 3.18
            },
            {
              "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": 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": 3.74,
              "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": 3.74,
              "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": 3.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 3.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 2.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.74,
              "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": 2.36
            },
            {
              "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": 2.36
            },
            {
              "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": 3.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.73
            },
            {
              "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": 3.74,
              "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": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 3.74,
              "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": 3.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.81
            },
            {
              "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": 3.74,
              "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": 3.03
            },
            {
              "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": 3.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.36
            },
            {
              "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": 2.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.18
            },
            {
              "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": 2.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.81
            },
            {
              "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": 3.18
            },
            {
              "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": 3.74,
              "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": 2.4
            },
            {
              "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": 2.4
            },
            {
              "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": 2.36
            },
            {
              "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": 2.43
            },
            {
              "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": 3.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.4
            },
            {
              "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": 2.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.43
            },
            {
              "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": 2.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.06
            },
            {
              "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": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 3.74,
              "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": 3.74,
              "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": 3.74,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 3.1
            },
            {
              "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": 3.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.36
            },
            {
              "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": 3.29
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 2.4
            },
            {
              "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": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 2.73
            },
            {
              "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": 2.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 3.74,
              "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": 3.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.74
            },
            {
              "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": 2.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.18
            },
            {
              "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": 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": 3.74,
              "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": 3.74,
              "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": 3.74,
              "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": 2.4
            },
            {
              "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": 2.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.74,
              "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": 2.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.73
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pre Cut Ext Wear 1 3-8 in New Image",
      "code_information": [
        {
          "code": "PX-CHHO14707",
          "type": "CDM"
        },
        {
          "code": "A4409",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.56,
          "discounted_cash": 6.21,
          "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": 6.14
            },
            {
              "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": 9.56,
              "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": 9.56,
              "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": 6.04
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "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": 8.13
            },
            {
              "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": 9.56,
              "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": 9.56,
              "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": 9.56,
              "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": 8.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "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": 6.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 6.14
            },
            {
              "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": 6.22
            },
            {
              "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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 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": 7.73
            },
            {
              "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": 6.04
            },
            {
              "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": 9.56,
              "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": 6.14
            },
            {
              "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": 9.56,
              "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": 9.56,
              "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": 9.56,
              "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": 5.26
            },
            {
              "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": 6.14
            },
            {
              "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 8.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 6.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "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": 7.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "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": 9.56,
              "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": 9.56,
              "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": 9.56,
              "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": 5.31
            },
            {
              "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": 5.31
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 8.13
            },
            {
              "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": 5.26
            },
            {
              "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": 6.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.84
            },
            {
              "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": 9.56,
              "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": 7.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 6.04
            },
            {
              "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": 8.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "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": 9.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 6.98
            },
            {
              "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": 2.61
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "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": 8.13
            },
            {
              "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": 9.56,
              "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": 9.56,
              "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": 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": 6.04
            },
            {
              "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": 6.14
            },
            {
              "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": 9.56,
              "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": 8.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.17
            },
            {
              "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
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 5.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 7.93
            },
            {
              "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": 9.56,
              "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": 64.2,
              "estimated_amount": 6.14
            },
            {
              "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": 7.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 6.04
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.56,
              "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": 9.56,
              "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": 9.56,
              "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": 7.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.98
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 6.22
            },
            {
              "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": 7.84
            },
            {
              "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": 9.56,
              "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": 6.98
            },
            {
              "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": 9.56,
              "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": 6.04
            },
            {
              "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": 5.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.56,
              "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": 9.56,
              "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": 7.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            }
          ]
        }
      ]
    },
    {
      "description": "Sodium",
      "code_information": [
        {
          "code": "PX-30101465",
          "type": "CDM"
        },
        {
          "code": "84295",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "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": 5.78
            },
            {
              "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": 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": 7.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "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": "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": "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 [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.05,
              "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": 6.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "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": 7.38
            },
            {
              "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.03,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 5.69
            },
            {
              "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": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "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": "MOLINA 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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": 9,
              "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": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "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": 5.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.03,
              "estimated_amount": 7.03
            },
            {
              "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 [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 OPEN CHOICE PPO [310210]",
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "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": 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": 7.89
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": "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 BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "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 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 PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 7.65
            },
            {
              "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": "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 [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "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": 7.38
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "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": 7.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "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": 6.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 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": 9,
              "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": 5.69
            },
            {
              "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": "MVP CIGNA [370425]",
              "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC 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": "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": "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": "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 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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "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": 7.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.03,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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,
              "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": 5.69
            },
            {
              "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": "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": "AETNA [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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "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": "MERITAIN AETNA [310325]",
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "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": 2.46
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "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": 7.65
            },
            {
              "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": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "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": "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 OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.05,
              "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": 9,
              "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": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": 7.89
            },
            {
              "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": "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": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "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": 5.69
            },
            {
              "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": 5.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "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": "HUMANA [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": "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.05,
              "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": 4.95
            },
            {
              "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 OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "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": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "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": 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": "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": "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 HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": 4.81,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "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": 7.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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 OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 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
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.03,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.03,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.03,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 7.65
            },
            {
              "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": "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": "AETNA [310]",
              "plan_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": "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 TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 7.46
            },
            {
              "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": "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": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.86,
              "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": 5.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.81,
              "estimated_amount": 4.81
            },
            {
              "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": "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 OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.04,
              "estimated_amount": 18.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.05,
              "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": 6.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            }
          ],
          "minimum": 4.81,
          "maximum": 18.04
        }
      ]
    },
    {
      "description": "Tubular Drsg Surgilast Size 3 Med Hand Arm Leg",
      "code_information": [
        {
          "code": "PX-CHMT03",
          "type": "CDM"
        },
        {
          "code": "A6457",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.17,
          "discounted_cash": 7.26,
          "payers_information": [
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.17,
              "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": 9.49
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.17,
              "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": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "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": 11.17,
              "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": 8.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 9.16
            },
            {
              "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": 3.05
            },
            {
              "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": 6.2
            },
            {
              "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": 11.17,
              "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": 7.06
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "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": 7.27
            },
            {
              "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": 9.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "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": 9.26
            },
            {
              "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": 11.17,
              "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": 11.17,
              "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": 9.16
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.38
            },
            {
              "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": 7.17
            },
            {
              "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": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "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": "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": "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": "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": "BUCKEYE COMMUNITY 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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.17,
              "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": 6.14
            },
            {
              "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": 9.8
            },
            {
              "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": "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": "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": "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.17,
              "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": 11.17,
              "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": 11.17,
              "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": 11.17,
              "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": 7.27
            },
            {
              "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": 6.2
            },
            {
              "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": 6.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.17,
              "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": 6.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "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": 7.17
            },
            {
              "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": "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 CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "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": 11.17,
              "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": 11.17,
              "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": 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 [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": "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "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": 11.17,
              "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": 7.06
            },
            {
              "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": "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": "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": 11.17,
              "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": 9.49
            },
            {
              "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": 11.17,
              "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": 9.49
            },
            {
              "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": "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 UMR OPTIONS [625335]",
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "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": "AETNA [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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.17,
              "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": 8.15
            },
            {
              "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": 11.17,
              "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": 11.17,
              "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": 7.06
            },
            {
              "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/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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 11.17,
              "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": 9.26
            },
            {
              "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": 9.04
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 0.9,
          "discounted_cash": 0.58,
          "payers_information": [
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "AETNA [310]",
              "plan_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": "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": "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": "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": "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": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "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": 0.57
            },
            {
              "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "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": 0.66
            },
            {
              "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": 0.5
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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 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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "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": 0.57
            },
            {
              "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": 0.9,
              "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": 0.9,
              "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": 0.9,
              "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": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.5
            },
            {
              "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": 0.9,
              "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": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE 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": "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 [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": "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN 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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "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": "BUCKEYE COMMUNITY 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": "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": "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": "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": "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": "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 OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.79
            },
            {
              "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "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": 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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.79
            },
            {
              "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": 0.9,
              "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": 0.9,
              "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": 0.58
            },
            {
              "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "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": 0.9,
              "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": 0.58
            },
            {
              "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 0.9,
              "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": 0.9,
              "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": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "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": 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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.66
            },
            {
              "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": 0.9,
              "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": 0.9,
              "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": 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": 0.57
            },
            {
              "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": "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": "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": "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": "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": "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 OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "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": 0.9,
              "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": 0.58
            },
            {
              "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": "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": "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": "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": "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": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "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": 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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "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": "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": "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"
            }
          ]
        }
      ]
    },
    {
      "description": "Tubular Drsg Tubigrip Size D Lg Arms Med Ankles Sm Knees",
      "code_information": [
        {
          "code": "PX-CHSM1437",
          "type": "CDM"
        },
        {
          "code": "A6457",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 70.62,
          "discounted_cash": 45.9,
          "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": 64.2,
              "estimated_amount": 45.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.13
            },
            {
              "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": 19.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "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": 45.34
            },
            {
              "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": 45.34
            },
            {
              "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": 57.91
            },
            {
              "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": 39.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 70.62,
              "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": 70.62,
              "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": 57.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 38.84
            },
            {
              "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": 70.62,
              "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": 70.62,
              "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": 44.63
            },
            {
              "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": 44.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.84
            },
            {
              "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": 70.62,
              "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": 45.34
            },
            {
              "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": 70.62,
              "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": 70.62,
              "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": 57.91
            },
            {
              "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": 70.62,
              "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": 58.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.55
            },
            {
              "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": 70.62,
              "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": 70.62,
              "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": 45.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 70.62,
              "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": 70.62,
              "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": 45.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.63
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.55
            },
            {
              "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": 51.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.91
            },
            {
              "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": 39.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 70.62,
              "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": 60.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 70.62,
              "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": 70.62,
              "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": 45.97
            },
            {
              "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": 57.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.97
            },
            {
              "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": 62.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 70.62,
              "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": 70.62,
              "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": 61.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.34
            },
            {
              "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": 57.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "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": 39.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.84
            },
            {
              "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": 60.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 70.62,
              "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": 70.62,
              "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": 70.62,
              "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": 58.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "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": 38.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.34
            },
            {
              "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": 45.97
            },
            {
              "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": 70.62,
              "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": 44.63
            },
            {
              "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": 45.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.55
            },
            {
              "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": 70.62,
              "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": 70.62,
              "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": 70.62,
              "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": 70.62,
              "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": 61.93
            },
            {
              "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": 70.62,
              "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": 45.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 70.62,
              "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": 70.62,
              "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": 70.62,
              "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": 70.62,
              "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": 70.62,
              "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": 57.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 70.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 70.62,
              "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": 70.62,
              "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": 45.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.91
            },
            {
              "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": 70.62,
              "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": 44.63
            },
            {
              "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": 70.62,
              "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": 70.62,
              "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": 60.03
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 7.06,
          "discounted_cash": 4.59,
          "payers_information": [
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.06,
              "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": 7.06,
              "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": 7.06,
              "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": 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": "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": "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": "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": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 7.06,
              "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": 3.92
            },
            {
              "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": 6.19
            },
            {
              "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": 5.85
            },
            {
              "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": 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": 4.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.71
            },
            {
              "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": 5.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 7.06,
              "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": 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": 4.46
            },
            {
              "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": 7.06,
              "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": 1.93
            },
            {
              "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": 3.88
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 5.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "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": 4.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.3
            },
            {
              "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": 7.06,
              "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": 7.06,
              "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": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 4.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.79
            },
            {
              "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": 4.53
            },
            {
              "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": 7.06,
              "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": 4.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 7.06,
              "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
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.79
            },
            {
              "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": 7.06,
              "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": 7.06,
              "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": 5.85
            },
            {
              "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": 3.92
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": 4.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 4.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.06
            },
            {
              "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": 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": 5.3
            },
            {
              "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 CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 3.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.06,
              "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": 3.88
            },
            {
              "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
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.06,
              "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": 7.06,
              "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": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "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": 7.06,
              "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": 5.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 5.15
            },
            {
              "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": 7.06,
              "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": 4.6
            },
            {
              "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": 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": 5.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 7.06,
              "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": 5.79
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.06,
              "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": 4.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 4.53
            },
            {
              "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": "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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 7.06,
              "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": 7.06,
              "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": 7.06,
              "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": 7.06,
              "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": 7.06,
              "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": 7.06,
              "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": 5.79
            },
            {
              "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": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.06,
              "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": 3.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.06,
              "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": 6.19
            },
            {
              "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": 7.06,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter 100% Silicone 2-Way 22 Fr 5cc Hydrogel",
      "code_information": [
        {
          "code": "PX-CHKN7605221",
          "type": "CDM"
        },
        {
          "code": "A4344",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.3,
          "discounted_cash": 6.69,
          "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": 6.61
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.3,
              "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": 10.3,
              "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": 10.3,
              "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": 10.3,
              "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": 9.03
            },
            {
              "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": 6.61
            },
            {
              "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": 10.3,
              "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": 7.52
            },
            {
              "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": 10.3,
              "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": 10.3,
              "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": 10.3,
              "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": 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": 8.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "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": 6.51
            },
            {
              "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": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 7.52
            },
            {
              "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": 5.72
            },
            {
              "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": "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.3,
              "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": 8.76
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.3,
              "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": 10.3,
              "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": 10.3,
              "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": 10.3,
              "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": 10.3,
              "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": 9.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 6.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 6.51
            },
            {
              "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": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 8.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 6.51
            },
            {
              "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": "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": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "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": "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": "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.71
            },
            {
              "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": 10.3,
              "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": 6.51
            },
            {
              "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": 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": 5.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.3,
              "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": 10.3,
              "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": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 10.3,
              "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": 8.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "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": 6.61
            },
            {
              "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": 6.71
            },
            {
              "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": "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": 10.3,
              "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": 8.45
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.3,
              "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": 10.3,
              "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": 8.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "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": 10.3,
              "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": 6.61
            },
            {
              "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": 10.3,
              "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": 7.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 7.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "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": 10.3,
              "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": 5.67
            },
            {
              "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": 10.3,
              "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": 2.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "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": 8.54
            },
            {
              "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": 8.54
            },
            {
              "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": 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": 6.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "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": 10.3,
              "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": 8.76
            },
            {
              "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": 10.3,
              "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": 9.03
            },
            {
              "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": "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 OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Drsg Bordered Cover Covrsite Plus 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CHUN59715000",
          "type": "CDM"
        },
        {
          "code": "A6203",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.94,
          "discounted_cash": 1.91,
          "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": 1.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.5
            },
            {
              "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": 2.94,
              "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": 1.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "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": 2.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.41
            },
            {
              "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": 2.94,
              "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": 2.94,
              "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": 2.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.41
            },
            {
              "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": 2.94,
              "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": 2.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 2.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 2.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 2.94,
              "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": 1.62
            },
            {
              "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": 1.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.41
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 1.62
            },
            {
              "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": 2.94,
              "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": 2.94,
              "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": 2.94,
              "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": 1.89
            },
            {
              "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": 2.5
            },
            {
              "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": 2.94,
              "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": 2.94,
              "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": 2.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.5
            },
            {
              "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": 1.91
            },
            {
              "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": 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": 2.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 2.94,
              "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": 2.94,
              "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": 1.89
            },
            {
              "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": 1.89
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.94,
              "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": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 1.62
            },
            {
              "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": 2.15
            },
            {
              "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": 2.58
            },
            {
              "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": 2.94,
              "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": 2.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.91
            },
            {
              "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": 1.89
            },
            {
              "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": 1.91
            },
            {
              "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": 1.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.5
            },
            {
              "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": 2.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.94,
              "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": 1.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "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": 1.89
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.15
            },
            {
              "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": 2.94,
              "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": 2.5
            },
            {
              "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": 2.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.62
            },
            {
              "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": 2.94,
              "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": 2.94,
              "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": 2.94,
              "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": 2.94,
              "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": 1.86
            },
            {
              "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": 1.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "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": 2.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 1.63
            },
            {
              "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": 1.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 1.86
            },
            {
              "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": 2.94,
              "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": 2.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 2.94,
              "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": 2.94,
              "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": 2.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.89
            },
            {
              "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": 2.5
            },
            {
              "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": 1.86
            },
            {
              "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": 1.86
            },
            {
              "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": 2.94,
              "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": 2.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "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": 2.94,
              "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": 2.5
            },
            {
              "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": 2.94,
              "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": 1.89
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC CT Abdomen W WO Contrast",
      "code_information": [
        {
          "code": "PX-35200029",
          "type": "CDM"
        },
        {
          "code": "74170",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1694,
          "discounted_cash": 1101.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "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": 1246.78
            },
            {
              "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": 160.36,
              "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": 931.7
            },
            {
              "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": 1240.01
            },
            {
              "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": 1485.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "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": 1102.79
            },
            {
              "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": 1389.08
            },
            {
              "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": 1694,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "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": 1439.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1694,
              "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": 1439.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1694
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1236.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1102.79
            },
            {
              "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": 1246.78
            },
            {
              "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": 1370.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1694,
              "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": 1270.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1389.08
            },
            {
              "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": 1389.08
            },
            {
              "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": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "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": 1389.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1240.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1240.01
            },
            {
              "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": 370.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1236.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "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": 1694,
              "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": 73.2,
              "estimated_amount": 1240.01
            },
            {
              "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": 1485.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 931.7
            },
            {
              "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": 1694,
              "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": 1694,
              "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": 1694,
              "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": 1102.79
            },
            {
              "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": 160.36,
              "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": 1439.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 931.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1240.01
            },
            {
              "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": 1404.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1404.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1694,
              "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": 1694,
              "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": 1102.79
            },
            {
              "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": 1245.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1404.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1694,
              "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": 73.5,
              "estimated_amount": 1245.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1270.5
            },
            {
              "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": 1439.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 931.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "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": 1101.1
            },
            {
              "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": 1490.72
            },
            {
              "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": 1102.79
            },
            {
              "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": 1240.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1694,
              "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": 1694,
              "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": 931.7
            },
            {
              "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": 161.96,
              "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": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1270.5
            },
            {
              "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": 160.36,
              "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": 1694,
              "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": 1439.9
            },
            {
              "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": 161.96,
              "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": 73.2,
              "estimated_amount": 1240.01
            },
            {
              "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": 163.63,
              "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": 163.63,
              "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": 1370.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1389.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 931.7
            },
            {
              "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": 1245.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1236.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "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": 462.46
            },
            {
              "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": 1246.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1236.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "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": 163.63,
              "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": 1694,
              "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": 1694,
              "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": 1246.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1389.08
            },
            {
              "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": 161.96,
              "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": 73.2,
              "estimated_amount": 1240.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1694,
              "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": 1694,
              "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": 1694,
              "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": 1694,
              "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": 1694,
              "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": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1246.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1389.08
            },
            {
              "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": 931.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1439.9
            },
            {
              "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": 1245.09
            },
            {
              "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": 160.36,
              "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": 1389.08
            },
            {
              "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": 168.38,
              "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": 1694,
              "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": 1236.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1236.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1694,
              "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": 161.96,
              "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": 161.96,
              "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": 168.38,
              "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": 168.38,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Basic Metabolic Panel Calcium Total",
      "code_information": [
        {
          "code": "PX-30100002",
          "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "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": "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": "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 OXFORD [625260]",
              "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "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": 40.88
            },
            {
              "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": 35.95
            },
            {
              "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 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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "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": 35.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.88
            },
            {
              "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": 31.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 45.3
            },
            {
              "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": 35.39
            },
            {
              "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": "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "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": 35.95
            },
            {
              "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": 46.42
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "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": 45.92
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 8.46,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.54,
              "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": 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": 40.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "AETNA [310]",
              "plan_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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.23,
              "estimated_amount": 9.23
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "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": "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": "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 30.8
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "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": 56,
              "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": 35.95
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "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": 35.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 8.46,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.54,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "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": 49.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 8.46,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.54,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": "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": "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": "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": "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "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": 36.4
            },
            {
              "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": "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": "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": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 8.46,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.54,
              "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": 56,
              "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": 56,
              "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": 31.08
            },
            {
              "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": 45.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 8.46,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.54,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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"
            }
          ],
          "minimum": 8.46,
          "maximum": 31.73
        }
      ]
    },
    {
      "description": "HC Carbamazepine Total So",
      "code_information": [
        {
          "code": "PX-30100490",
          "type": "CDM"
        },
        {
          "code": "80156",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 138,
          "discounted_cash": 89.7,
          "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": 88.6
            },
            {
              "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": 75.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 89.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "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": 87.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.22
            },
            {
              "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": 88.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.28,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "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": 117.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.3,
              "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": 114.4
            },
            {
              "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": 88.6
            },
            {
              "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": 87.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 76.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.6
            },
            {
              "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": 111.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 117.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 103.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.59
            },
            {
              "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": 121.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "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": 89.84
            },
            {
              "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": 113.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.6
            },
            {
              "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": 89.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 138
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "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": 138,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "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": 87.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 103.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 103.5
            },
            {
              "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": 121.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.74
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.28,
              "estimated_amount": 21.28
            },
            {
              "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": 113.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 114.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.3,
              "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": 117.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 111.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.28,
              "estimated_amount": 21.28
            },
            {
              "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": 37.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "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": 121.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.9
            },
            {
              "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": 87.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.57,
              "estimated_amount": 14.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "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": 117.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 138,
              "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": 75.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.74
            },
            {
              "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": 76.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 114.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.9
            },
            {
              "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": 88.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.74
            },
            {
              "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": 138,
              "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": 88.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.6
            },
            {
              "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": 117.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            },
            {
              "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": 76.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 14.57,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.72,
              "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": 89.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.3
            },
            {
              "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": 100.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.64,
              "estimated_amount": 54.64
            }
          ],
          "minimum": 14.57,
          "maximum": 54.64
        }
      ]
    },
    {
      "description": "Contact Drsg Cutimed Sorbact Swab 4 in X 8 In",
      "code_information": [
        {
          "code": "PX-CH-JB7266203",
          "type": "CDM"
        },
        {
          "code": "A6207",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.34,
          "discounted_cash": 10.62,
          "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": 10.49
            },
            {
              "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": 10.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 9.07
            },
            {
              "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": 13.55
            },
            {
              "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": 16.34,
              "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": 16.34,
              "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": 16.34,
              "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": 16.34,
              "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": 13.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 10.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 16.34,
              "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": 13.89
            },
            {
              "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": 16.34,
              "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": 8.99
            },
            {
              "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": 16.34,
              "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": 12.26
            },
            {
              "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": 16.34,
              "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": 16.34,
              "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": 16.34,
              "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": 16.34,
              "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": 13.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 16.34,
              "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": 16.34,
              "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": 8.99
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.34,
              "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": 10.49
            },
            {
              "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": 9.07
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.34,
              "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": 10.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.49
            },
            {
              "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": 13.4
            },
            {
              "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": 10.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "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": 16.34,
              "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": 10.33
            },
            {
              "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": 16.34,
              "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": 13.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.49
            },
            {
              "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": 16.34,
              "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": 16.34,
              "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": 13.89
            },
            {
              "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": 10.64
            },
            {
              "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": 14.38
            },
            {
              "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": 14.33
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.34,
              "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": 11.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 13.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.49
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.49
            },
            {
              "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": 4.46
            },
            {
              "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": 14.33
            },
            {
              "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": 16.34,
              "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": 13.89
            },
            {
              "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": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.89
            },
            {
              "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": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 10.62
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.93
            },
            {
              "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": 16.34,
              "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": 10.33
            },
            {
              "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": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 10.64
            },
            {
              "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": 10.49
            },
            {
              "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": 13.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.4
            },
            {
              "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": 8.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.4
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.49
            },
            {
              "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": 16.34,
              "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": 11.93
            },
            {
              "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": 16.34,
              "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": 16.34,
              "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": 16.34,
              "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": 16.34,
              "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": 9.07
            },
            {
              "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": 13.22
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.34,
              "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": 13.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "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": 10.49
            },
            {
              "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": 16.34,
              "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": 13.22
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Nutritional Ensure Plus Vanilla 8oz Can",
      "code_information": [
        {
          "code": "PX-CH-ROS50464",
          "type": "CDM"
        },
        {
          "code": "B4152",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.43,
          "discounted_cash": 1.58,
          "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": 1.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.77
            },
            {
              "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": 1.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.34
            },
            {
              "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": 1.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 2.43,
              "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": 2.43,
              "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": 2.07
            },
            {
              "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": 2.07
            },
            {
              "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": 1.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 2.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 2.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 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": 1.56
            },
            {
              "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": 1.77
            },
            {
              "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": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 1.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.07
            },
            {
              "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": 2.43,
              "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": 2.43,
              "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": 2.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.56
            },
            {
              "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": 2.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.82
            },
            {
              "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": 2.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.01
            },
            {
              "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": 1.56
            },
            {
              "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": 1.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.43,
              "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": 2.43,
              "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": 2.01
            },
            {
              "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": 1.58
            },
            {
              "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": 1.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 2.07
            },
            {
              "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": 1.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.34
            },
            {
              "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": 2.43,
              "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": 1.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 1.99
            },
            {
              "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": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 2.43,
              "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": 1.58
            },
            {
              "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": 1.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.34
            },
            {
              "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": 1.35
            },
            {
              "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": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.54
            },
            {
              "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": 2.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 2.43,
              "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": 1.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.43,
              "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": 1.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 2.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "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": 1.56
            },
            {
              "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": 1.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.77
            },
            {
              "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": 1.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.35
            },
            {
              "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": 2.43,
              "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": 1.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Underpad 30 in X 30 in Prevail",
      "code_information": [
        {
          "code": "PX-CH-1QUP-100",
          "type": "CDM"
        },
        {
          "code": "T4541",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.57,
          "discounted_cash": 0.37,
          "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": 0.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.57,
              "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": 0.5
            },
            {
              "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": 0.37
            },
            {
              "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": 0.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.36
            },
            {
              "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": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.43
            },
            {
              "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": 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": 0.42
            },
            {
              "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": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.57,
              "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": 0.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 0.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.48
            },
            {
              "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": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.48
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.57,
              "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": 0.36
            },
            {
              "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": 0.5
            },
            {
              "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": 0.57,
              "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": 0.57,
              "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": 0.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.31
            },
            {
              "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": 0.57,
              "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": 0.57,
              "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": 0.57,
              "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": 0.37
            },
            {
              "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": 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": 0.47
            },
            {
              "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": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.57,
              "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": 0.48
            },
            {
              "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": 0.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.43
            },
            {
              "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": 0.48
            },
            {
              "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": 0.37
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.57,
              "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": 0.57,
              "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": 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": 0.48
            },
            {
              "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": 0.37
            },
            {
              "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": 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": 0.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 0.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.43
            },
            {
              "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": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.57,
              "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": 0.57,
              "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": 0.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.37
            },
            {
              "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": 0.47
            }
          ]
        }
      ]
    },
    {
      "description": "HC Walker Boot",
      "code_information": [
        {
          "code": "PX-27400009",
          "type": "CDM"
        },
        {
          "code": "L4361",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 131,
          "discounted_cash": 85.15,
          "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": 84.1
            },
            {
              "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": 85.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "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": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 84.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 108.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 319.86,
              "additional_payer_notes": "DMEPOS 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": 95.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "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": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 131,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.28
            },
            {
              "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": 108.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 131,
              "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": 131,
              "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": 131,
              "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": 108.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 95.63
            },
            {
              "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": 84.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "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": 72.71
            },
            {
              "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": 72.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 84.1
            },
            {
              "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": 84.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS 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": 84.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 319.86,
              "additional_payer_notes": "DMEPOS 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": 72.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS 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": 131,
              "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": 131,
              "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": 84.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 84.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 319.86,
              "additional_payer_notes": "DMEPOS 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": 84.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS 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": 84.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 72.71
            },
            {
              "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": 84.1
            },
            {
              "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": 95.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.1
            },
            {
              "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": 105.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 105.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 131,
              "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": 131,
              "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": 85.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            }
          ],
          "minimum": 304.63,
          "maximum": 304.63
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Uro Up to 2 3/4 in High Ouput",
      "code_information": [
        {
          "code": "PX-CH-HO80070",
          "type": "CDM"
        },
        {
          "code": "A6154",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.18,
          "discounted_cash": 7.92,
          "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": 7.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.85
            },
            {
              "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": 9.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.18,
              "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": 7.7
            },
            {
              "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": 7.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.14
            },
            {
              "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": 9.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.7
            },
            {
              "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": 12.18,
              "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": 9.14
            },
            {
              "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": 7.82
            },
            {
              "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": 12.18,
              "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": 6.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.89
            },
            {
              "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": 7.7
            },
            {
              "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": 12.18,
              "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": 7.82
            },
            {
              "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": 10.68
            },
            {
              "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": 12.18,
              "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": 12.18,
              "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": 12.18,
              "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": 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": 7.93
            },
            {
              "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": 12.18,
              "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": 12.18,
              "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": 10.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.18
            },
            {
              "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": 7.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.18,
              "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": 10.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.18,
              "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": 12.18,
              "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": 10.35
            },
            {
              "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": 7.93
            },
            {
              "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": 7.7
            },
            {
              "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": 6.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.99
            },
            {
              "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": 12.18,
              "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": 9.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.1
            },
            {
              "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": 12.18,
              "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": 12.18,
              "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": 12.18,
              "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": 10.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.18,
              "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": 12.18,
              "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": 12.18,
              "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": 10.35
            },
            {
              "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": 6.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.99
            },
            {
              "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": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.18,
              "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": 10.35
            },
            {
              "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": 10.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.82
            },
            {
              "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": 9.99
            },
            {
              "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": 10.72
            },
            {
              "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": 12.18,
              "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": 12.18,
              "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": 12.18,
              "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": 12.18,
              "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": 7.82
            },
            {
              "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": 7.82
            },
            {
              "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": 12.18,
              "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": 10.35
            },
            {
              "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": 12.18,
              "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": 10.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.18,
              "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": 7.93
            },
            {
              "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": 12.18,
              "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": 12.18,
              "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": 10.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.82
            },
            {
              "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": 7.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 12.18,
              "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": 12.18,
              "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": 6.76
            },
            {
              "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": 12.18,
              "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": 12.18,
              "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": 10.35
            },
            {
              "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": 9.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.89
            },
            {
              "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": 10.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.18,
              "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": 12.18,
              "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": 7.93
            },
            {
              "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": 3.33
            },
            {
              "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": 8.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.18,
              "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": 10.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.35
            }
          ]
        }
      ]
    },
    {
      "description": "Walking Boot Pneum Fit to Pt W/Adj",
      "code_information": [
        {
          "code": "PX-27400019",
          "type": "CDM"
        },
        {
          "code": "L4360",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 833,
          "discounted_cash": 541.45,
          "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": 534.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 608.09
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 319.86,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 833,
              "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": 462.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 534.79
            },
            {
              "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": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 462.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 608.09
            },
            {
              "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": 534.79
            },
            {
              "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": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 690.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 608.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 534.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 534.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 534.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 534.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 608.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 534.79
            },
            {
              "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": 534.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 319.86,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 542.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 608.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 542.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 690.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 542.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 462.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 833,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS 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": 608.09
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS 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": 534.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 534.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 542.28
            },
            {
              "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": 673.9
            },
            {
              "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": 542.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 319.86,
              "additional_payer_notes": "DMEPOS 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": 833,
              "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": 833,
              "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": 462.32
            },
            {
              "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": 534.79
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 690.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 833,
              "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": 833,
              "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": 833,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 304.63,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 307.68,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 673.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 304.63,
              "estimated_amount": 304.63
            }
          ],
          "minimum": 304.63,
          "maximum": 304.63
        }
      ]
    },
    {
      "description": "Immobilizer Knee Off the Shelf",
      "code_information": [
        {
          "code": "PX-27400035",
          "type": "CDM"
        },
        {
          "code": "L1830",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 45,
          "discounted_cash": 29.25,
          "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": 64.2,
              "estimated_amount": 28.89
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "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": 32.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "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": 45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "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": 24.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 70.22,
              "additional_payer_notes": "DMEPOS 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": 24.98
            },
            {
              "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": 28.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.89
            },
            {
              "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": 29.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "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": 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": 32.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.85
            },
            {
              "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": 24.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "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": 66.88,
              "estimated_amount": 66.88
            },
            {
              "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": 29.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 67.55,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "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": 28.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 28.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 67.55,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 70.22,
              "additional_payer_notes": "DMEPOS 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": 28.89
            },
            {
              "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": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "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": 28.89
            },
            {
              "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": 36.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 45,
              "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": 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": 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": 28.89
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 67.55,
              "additional_payer_notes": "DMEPOS 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": 37.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 37.31
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 45,
              "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": 29.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 67.55,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 66.88,
              "estimated_amount": 66.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 67.55,
              "additional_payer_notes": "DMEPOS 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": 28.89
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 66.88,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 70.22,
              "additional_payer_notes": "DMEPOS 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": 28.89
            },
            {
              "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": 37.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 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": 32.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.3
            },
            {
              "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": 45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": 45,
              "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": 32.85
            }
          ],
          "minimum": 66.88,
          "maximum": 66.88
        }
      ]
    },
    {
      "description": "HC Tube Trach Speaking Passy Muir",
      "code_information": [
        {
          "code": "PX-27400051",
          "type": "CDM"
        },
        {
          "code": "L8501",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 225,
          "discounted_cash": 146.25,
          "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": 144.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 147.38
            },
            {
              "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": 147.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 147.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 123.75
            },
            {
              "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": 197.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 147.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 184.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 124.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 146.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 186.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 225
            },
            {
              "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": 144.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "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": 146.48
            },
            {
              "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": 197.33
            },
            {
              "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": 198
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 123.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 143.78
            },
            {
              "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": 225,
              "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": 143.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 184.5
            },
            {
              "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": 124.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 123.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 123.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "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": 147.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "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": 146.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 184.5
            },
            {
              "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": 184.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "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": 146.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 184.5
            },
            {
              "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": 184.5
            },
            {
              "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": 61.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "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": 225,
              "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": 186.53
            },
            {
              "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": 144.23
            },
            {
              "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": 191.25
            },
            {
              "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": 124.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 146.48
            },
            {
              "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": 147.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 184.5
            },
            {
              "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": 191.25
            },
            {
              "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": 144.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 143.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "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": 137.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 147.38
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 146.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 143.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 123.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 164.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 168.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "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": 184.5
            },
            {
              "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": 164.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 225,
              "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": 123.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 137.25
            },
            {
              "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": 225,
              "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": 147.38
            },
            {
              "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": 124.88
            },
            {
              "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": 225,
              "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": 164.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 182.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 168.75
            },
            {
              "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": 182.03
            },
            {
              "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": 186.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 191.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 168.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 144.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 123.75
            }
          ]
        }
      ]
    },
    {
      "description": "Pms2 Gene Full Seq Analysis Sendout",
      "code_information": [
        {
          "code": "PX-30101233",
          "type": "CDM"
        },
        {
          "code": "81317",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2718,
          "discounted_cash": 1766.7,
          "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": 1744.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1984.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1984.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2253.22
            },
            {
              "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": 1744.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2253.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1769.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2038.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1984.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1744.96
            },
            {
              "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": 2228.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2228.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1508.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2038.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1744.96
            },
            {
              "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": 1508.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2718
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2228.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "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": 2718,
              "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": 1508.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "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": 1717.78
            },
            {
              "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": 2383.69
            },
            {
              "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": 1717.78
            },
            {
              "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": 1744.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2228.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1494.9
            },
            {
              "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": 1744.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1769.42
            },
            {
              "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": 2253.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "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": 2310.3
            },
            {
              "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": 1744.96
            },
            {
              "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": 1769.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1494.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1744.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1494.9
            },
            {
              "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": 1769.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1717.78
            },
            {
              "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": 2310.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1494.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1984.14
            },
            {
              "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": 1508.49
            },
            {
              "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": 2198.86
            },
            {
              "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": 742.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1494.9
            },
            {
              "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": 2383.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1717.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2228.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1494.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 681.28,
              "estimated_amount": 681.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 681.28,
              "estimated_amount": 681.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1744.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1769.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "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": 1984.14
            },
            {
              "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": 2718,
              "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": 2391.84
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2718,
              "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": 1717.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2038.5
            },
            {
              "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": 2228.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2228.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1717.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2536.88,
              "estimated_amount": 2536.88
            },
            {
              "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": 1766.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            },
            {
              "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": 1494.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1984.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1744.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1744.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2228.76
            },
            {
              "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": 1717.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1717.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1744.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2198.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2310.3
            }
          ],
          "minimum": 681.28,
          "maximum": 2536.88
        }
      ]
    },
    {
      "description": "HC Venipuncture",
      "code_information": [
        {
          "code": "PX-30000001",
          "type": "CDM"
        },
        {
          "code": "36415",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20,
          "discounted_cash": 13,
          "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": 12.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 20
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "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": 20,
              "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": 14.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.92,
              "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": 16.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 12.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 16.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.84
            },
            {
              "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": 12.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "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": 11.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.58
            },
            {
              "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": 11.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.02
            },
            {
              "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": 13.02
            },
            {
              "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": 5.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.27,
              "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": 12.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 12.64
            },
            {
              "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": 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": 14.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.27,
              "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": 20,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "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": 17.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 12.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.17,
              "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": 16.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "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": 17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.92,
              "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": 17.54
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 12.84
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.92,
              "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": 12.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.64
            },
            {
              "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": 12.84
            },
            {
              "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": 11.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "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": 17.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 20,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.17,
              "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": 13.02
            },
            {
              "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": 16.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 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": 11.1
            },
            {
              "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": 16.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.92,
              "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": 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": 14.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 8.83,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.92,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.17,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 14.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.14,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 12.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.83,
              "estimated_amount": 8.83
            },
            {
              "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": 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": 16.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 12.84
            }
          ],
          "minimum": 3.17,
          "maximum": 32.14
        }
      ]
    },
    {
      "description": "HC Smear Nasal Eosinophils",
      "code_information": [
        {
          "code": "PX-30000039",
          "type": "CDM"
        },
        {
          "code": "89190",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 250,
          "discounted_cash": 162.5,
          "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": 160.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 160.5
            },
            {
              "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": 162.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.75
            },
            {
              "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": 220
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 182.5
            },
            {
              "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": 212.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "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": 212.5
            },
            {
              "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": 250,
              "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": 160.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 205
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 137.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 182.5
            },
            {
              "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": 138.75
            },
            {
              "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": 202.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 160.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 158
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 137.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 182.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 160.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 138.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 187.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "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": 160.5
            },
            {
              "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": 205
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "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": 187.5
            },
            {
              "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": 137.5
            },
            {
              "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": 162.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 207.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 158
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 160.5
            },
            {
              "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": 219.25
            },
            {
              "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": 162.5
            },
            {
              "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": 138.75
            },
            {
              "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": 207.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 205
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 68.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 137.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 137.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 205
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 182.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 158
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 138.75
            },
            {
              "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": 158
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "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": 160.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 250
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 207.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 158
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 212.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 160.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 160.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 205
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 250,
              "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": 205
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 137.5
            },
            {
              "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": 205
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 158
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 137.5
            },
            {
              "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": 158
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 158
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 219.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 202.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 182.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "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": 182.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 205
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.71,
              "estimated_amount": 21.71
            },
            {
              "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": 160.5
            },
            {
              "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": 160.5
            },
            {
              "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": 212.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 187.5
            },
            {
              "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": 250,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 4.76,
          "maximum": 21.71
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Border Mepilex Lite 3 in X 3 In",
      "code_information": [
        {
          "code": "PX-CH-SM281200",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.72,
          "discounted_cash": 3.07,
          "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": 3.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.07
            },
            {
              "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": 2.6
            },
            {
              "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": 4.72,
              "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": 2.6
            },
            {
              "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": 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": 4.14
            },
            {
              "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": 4.72,
              "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": 4.72,
              "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": 2.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.07
            },
            {
              "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": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 3.45
            },
            {
              "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": 4.72,
              "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": 2.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.98
            },
            {
              "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": 4.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.03
            },
            {
              "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": 4.72,
              "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": 4.72,
              "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": 3.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.72,
              "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": 4.72,
              "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": 3.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 3.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 4.72,
              "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": 3.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 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": 3.45
            },
            {
              "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": 4.72,
              "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": 3.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.72,
              "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": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 3.03
            },
            {
              "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": 4.72,
              "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": 2.98
            },
            {
              "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": 4.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 4.72,
              "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": 2.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 4.72,
              "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": 3.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.6
            },
            {
              "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": 3.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.01
            },
            {
              "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": 4.72,
              "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": 4.72,
              "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": 4.72,
              "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": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 3.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.07
            },
            {
              "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": 3.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.6
            },
            {
              "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": 4.72,
              "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": 4.72,
              "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": 2.62
            },
            {
              "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": 3.91
            },
            {
              "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": 4.72,
              "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": 4.72,
              "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": 4.72,
              "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": 4.72,
              "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": 3.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.54
            },
            {
              "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": 2.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.45
            },
            {
              "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": 4.72,
              "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": 3.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.54
            },
            {
              "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": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 4.72,
              "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": 3.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.87
            },
            {
              "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": 1.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 3.45
            },
            {
              "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": 3.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.6
            },
            {
              "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": 3.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 4.01
            },
            {
              "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": 4.72,
              "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": 2.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.72,
              "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": 4.01
            },
            {
              "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": 4.72,
              "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": 3.07
            }
          ]
        }
      ]
    },
    {
      "description": "HC Kras Gene 7 Mutation Panel Tumor",
      "code_information": [
        {
          "code": "PX-30100075",
          "type": "CDM"
        },
        {
          "code": "81275",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2994,
          "discounted_cash": 1946.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "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": 1497
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 193.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.18,
              "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": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2185.62
            },
            {
              "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": 2185.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2185.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1946.1
            },
            {
              "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": 2544.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 172.2,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 217.72,
              "estimated_amount": 217.72
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2185.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2185.62
            },
            {
              "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": 748.5
            },
            {
              "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": "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": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2634.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 134.27,
              "estimated_amount": 134.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2455.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "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": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2994
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1646.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 193.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.18,
              "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": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2455.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2185.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 193.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.18,
              "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": 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": 2544.9
            },
            {
              "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": 2455.08
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "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": 2455.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "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": 2544.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1646.7
            },
            {
              "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": 1646.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "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": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2455.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2245.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1646.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2455.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 193.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 193.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 195.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 655.69
            },
            {
              "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": 1497
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1646.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "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": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "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 [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1646.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 134.27,
              "estimated_amount": 134.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2245.5
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2455.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 172.2,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2245.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 217.72,
              "estimated_amount": 217.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1646.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 1871.25
            },
            {
              "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": 2455.08
            },
            {
              "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": 1871.25
            },
            {
              "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": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2994,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "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": "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": 1871.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 1497
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2544.9
            }
          ],
          "minimum": 134.27,
          "maximum": 724.69
        }
      ]
    },
    {
      "description": "HC Ot Drive High Complexity",
      "code_information": [
        {
          "code": "PX-43400012",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 272,
          "discounted_cash": 176.8,
          "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": 174.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "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": 239.36
            },
            {
              "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": 174.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 177.07
            },
            {
              "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": 223.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 176.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "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": 225.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "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": 150.96
            },
            {
              "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": 74.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "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": 231.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "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": 170.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "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": 177.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 220.05
            },
            {
              "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": 223.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "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": 272,
              "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": 238.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "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": 177.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 177.07
            },
            {
              "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": 231.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "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": 174.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "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": 171.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 176.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "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": 170.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 272,
              "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": 204
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "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": 170.82
            },
            {
              "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": 176.8
            },
            {
              "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": 272,
              "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": 174.62
            },
            {
              "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": 171.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 177.07
            },
            {
              "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": 223.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "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": 174.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "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": 220.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 272
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 204
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 272,
              "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": 149.6
            },
            {
              "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": 198.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "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": 150.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 176.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "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": 171.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 204
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "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": 272,
              "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": 231.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "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": 174.62
            },
            {
              "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": 149.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            },
            {
              "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": 238.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.6
            },
            {
              "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": 150.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 223.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 231.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 170.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 176.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.56
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Sponge N/S Non Woven 4 in X 4 in Cardinal",
      "code_information": [
        {
          "code": "PX-CH-IMC55CNWS444",
          "type": "CDM"
        },
        {
          "code": "A6216",
          "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": "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": "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": "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": "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": "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": "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": "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 GEHA [625285]",
              "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 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": "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": "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": "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": "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/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": "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": "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": "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": "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": "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": "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": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": "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 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": "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE 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": "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": "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 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 NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "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": 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": 0.04
            },
            {
              "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 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": "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 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": "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": "MED MUTUAL SUPERMED PPO [485210]",
              "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": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "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": 0.04
            },
            {
              "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 CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": "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": "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": "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": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": "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": "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 MANAGED MEDICARE [624]",
              "plan_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": "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": "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 ELECT CHOICE [310200]",
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC 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": "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 HEALTHREACH PREFERRED [310203]",
              "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",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "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": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "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": "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": "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": "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": "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": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "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": "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": "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": "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": "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": "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 PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            }
          ]
        }
      ]
    },
    {
      "description": "Calcitonin Sendout",
      "code_information": [
        {
          "code": "PX-30100164",
          "type": "CDM"
        },
        {
          "code": "82308",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 68,
          "discounted_cash": 44.2,
          "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": 43.66
            },
            {
              "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": 44.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.79,
              "estimated_amount": 26.79
            },
            {
              "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": 68,
              "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": 37.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.13,
              "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": 49.64
            },
            {
              "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": 59.64
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "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": 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": 42.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.79,
              "estimated_amount": 26.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.13,
              "estimated_amount": 39.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.13,
              "estimated_amount": 39.13
            },
            {
              "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": 42.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 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": 43.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.76
            },
            {
              "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": 55.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "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": 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": 43.66
            },
            {
              "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": 43.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.06,
              "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": 68,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.79,
              "estimated_amount": 26.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.79,
              "estimated_amount": 26.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.06,
              "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": 37.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 56.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.66
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.13,
              "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": 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": 59.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.13,
              "estimated_amount": 39.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.79,
              "estimated_amount": 26.79
            },
            {
              "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": 37.74
            },
            {
              "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": 37.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 68,
              "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": 43.66
            },
            {
              "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": 55.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.79,
              "estimated_amount": 26.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.76
            },
            {
              "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": 44.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.66
            },
            {
              "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": 37.74
            },
            {
              "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": 49.64
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 28.13,
              "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": 57.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.06,
              "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": 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": 55.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.76
            },
            {
              "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": 18.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 56.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "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": 59.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.79,
              "estimated_amount": 26.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.98
            },
            {
              "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": 42.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 100.46,
              "estimated_amount": 100.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.4
            },
            {
              "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": 43.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.27
            },
            {
              "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": 56.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 26.79,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 27.06,
              "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": 44.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.8
            },
            {
              "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": 55.76
            },
            {
              "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": 44.27
            }
          ],
          "minimum": 26.79,
          "maximum": 100.46
        }
      ]
    },
    {
      "description": "HC Calcium Total",
      "code_information": [
        {
          "code": "PX-30100165",
          "type": "CDM"
        },
        {
          "code": "82310",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "minimum": 4.43,
          "maximum": 19.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": 4.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": 7.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": 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": 5.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.53,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 7.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "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": 6.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.53,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "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": "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.42,
              "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,
              "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": 45,
              "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": 7.38
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "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": 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": "UHC 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": "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": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "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": "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 OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.53,
              "estimated_amount": 7.53
            },
            {
              "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 [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.42,
              "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": 6.75
            },
            {
              "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": "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": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.43,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "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": 4.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "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": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": 4.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.16,
              "estimated_amount": 5.16
            },
            {
              "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": 6.57
            },
            {
              "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": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "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": 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": 7.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 5.16,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.21,
              "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": 4.95
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.41,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            },
            {
              "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": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.35,
              "estimated_amount": 19.35
            }
          ]
        }
      ]
    },
    {
      "description": "Cocaine Quantitative Sendout",
      "code_information": [
        {
          "code": "PX-30100194",
          "type": "CDM"
        },
        {
          "code": "80353",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 112,
          "discounted_cash": 72.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.9
            },
            {
              "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": 61.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 71.9
            },
            {
              "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": 62.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 71.9
            },
            {
              "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": 92.85
            },
            {
              "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": 95.2
            },
            {
              "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": 70.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 62.16
            },
            {
              "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": 71.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 95.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 30.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.78
            },
            {
              "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": 112,
              "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": 95.2
            },
            {
              "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": 95.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.91
            },
            {
              "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": 91.84
            },
            {
              "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": 91.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.9
            },
            {
              "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": 72.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.6
            },
            {
              "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": 98.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "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": 62.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.9
            },
            {
              "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": 71.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 72.8
            },
            {
              "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": 81.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 112,
              "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": 71.9
            },
            {
              "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": 71.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "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": 72.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 98.56
            },
            {
              "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": 91.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 112,
              "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": 70.78
            },
            {
              "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": 98.22
            },
            {
              "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": 90.61
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 95.2
            },
            {
              "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": 112,
              "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": 112,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 90.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 112
            },
            {
              "payer_name": "MOLINA 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,
              "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": 71.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.6
            },
            {
              "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": 70.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 112,
              "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": 112,
              "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": 62.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 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": 70.78
            },
            {
              "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": 70.78
            }
          ],
          "minimum": 12.85,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "HC Human Growth Hormone (Hgh)",
      "code_information": [
        {
          "code": "PX-30100273",
          "type": "CDM"
        },
        {
          "code": "83003",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 276,
          "discounted_cash": 179.4,
          "minimum": 14.3,
          "maximum": 62.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "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": 138
            },
            {
              "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": "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": "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "payer_name": "UHC 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": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.84,
              "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": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "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": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "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": 179.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.36,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.5,
              "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": 138
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.67,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.67,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.67,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.3,
              "estimated_amount": 14.3
            },
            {
              "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": 276,
              "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": 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": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.67,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.5,
              "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": 226.32
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.36,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.36,
              "estimated_amount": 24.36
            },
            {
              "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": 234.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.84,
              "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": 242.88
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.84,
              "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": 234.6
            },
            {
              "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "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": 124.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "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": "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 [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.3,
              "estimated_amount": 14.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.3,
              "estimated_amount": 14.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "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": "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.84,
              "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": 45,
              "estimated_amount": 124.2
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "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": 151.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.67,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "payer_name": "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": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "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": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 124.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 138
            },
            {
              "payer_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": "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 38.2,
              "estimated_amount": 38.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 62.51,
              "estimated_amount": 62.51
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.67,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.67,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.3,
              "estimated_amount": 14.3
            },
            {
              "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": 234.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.67,
              "estimated_amount": 16.67
            },
            {
              "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": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207
            }
          ]
        }
      ]
    },
    {
      "description": "Alginate Ag Silvercel 2 in X 2 In",
      "code_information": [
        {
          "code": "PX-CH-JJ800202",
          "type": "CDM"
        },
        {
          "code": "A6196",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.51,
          "discounted_cash": 3.58,
          "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": 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": 4.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.51,
              "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": 3.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 3.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.52
            },
            {
              "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": 5.51,
              "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": 4.52
            },
            {
              "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": 5.51,
              "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": 5.51,
              "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": 5.51,
              "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": 4.02
            },
            {
              "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": 5.51,
              "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": 3.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.54
            },
            {
              "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": 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": 3.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.54
            },
            {
              "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": 5.51,
              "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": 5.51,
              "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": 5.51,
              "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": 4.52
            },
            {
              "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": 5.51,
              "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": 5.51,
              "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": 5.51,
              "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": 3.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "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": 4.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 5.51,
              "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": 3.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 5.51,
              "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": 5.51,
              "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": 3.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 5.51,
              "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": 3.48
            },
            {
              "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": 3.59
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.51,
              "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": 4.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.06
            },
            {
              "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": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "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": 3.03
            },
            {
              "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": 3.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 5.51,
              "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": 5.51,
              "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": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 4.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "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": 3.06
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.52
            },
            {
              "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": 4.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.57
            },
            {
              "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": 4.68
            },
            {
              "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": 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": 4.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "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": 5.51,
              "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": 5.51,
              "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": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 5.51,
              "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": 5.51,
              "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": 3.54
            },
            {
              "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": 3.54
            },
            {
              "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 TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.51,
              "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": 5.51,
              "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": 4.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 3.54
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "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": 5.51,
              "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": 5.51,
              "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": 4.68
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.51
            },
            {
              "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": "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": "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 OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 3.59
            },
            {
              "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": 4.57
            },
            {
              "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": 3.48
            },
            {
              "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": 5.51,
              "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": 1.5
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 4.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.59
            }
          ]
        }
      ]
    },
    {
      "description": "HC Immunassay Noninfect Agnt Qnt Nos",
      "code_information": [
        {
          "code": "PX-30100297",
          "type": "CDM"
        },
        {
          "code": "83520",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 460,
          "discounted_cash": 299,
          "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": 295.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 295.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 377.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 345
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 299
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 253
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 253
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 253
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 377.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "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": 404.8
            },
            {
              "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": 391
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "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": 295.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 377.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.27,
              "estimated_amount": 17.27
            },
            {
              "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": 372.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 299.46
            },
            {
              "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": 299.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 460
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.72
            },
            {
              "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": 403.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 345
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 299.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 253
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 295.32
            },
            {
              "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": 295.32
            },
            {
              "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": 377.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 255.3
            },
            {
              "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": 460,
              "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": 391
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 253
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.91,
              "estimated_amount": 18.91
            },
            {
              "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": 290.72
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 299.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 377.2
            },
            {
              "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": 377.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 377.2
            },
            {
              "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": 290.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.27,
              "estimated_amount": 17.27
            },
            {
              "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": 255.3
            },
            {
              "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": 381.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 295.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.44,
              "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": 403.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.27,
              "estimated_amount": 17.27
            },
            {
              "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": 295.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "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": 335.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.27,
              "estimated_amount": 17.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 295.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 381.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.44,
              "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": 460,
              "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": 290.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.27,
              "estimated_amount": 17.27
            },
            {
              "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": 295.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.8
            },
            {
              "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": 391
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 255.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 372.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 391
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 381.34
            },
            {
              "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": 295.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "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": 17.27,
              "estimated_amount": 17.27
            },
            {
              "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": 255.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.44,
              "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": 460,
              "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": 299.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 253
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.91,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.27,
              "estimated_amount": 17.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 295.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 295.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 345
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.72
            },
            {
              "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": 125.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.91,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 377.2
            },
            {
              "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": 290.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 253
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 17.27,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 17.27,
          "maximum": 64.76
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Border Kerrafoam Heel",
      "code_information": [
        {
          "code": "PX-CH-87CWL1024",
          "type": "CDM"
        },
        {
          "code": "A6213",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14.27,
          "discounted_cash": 9.28,
          "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": 9.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.85
            },
            {
              "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": 14.27,
              "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": 14.27,
              "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": 14.27,
              "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": 9.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 9.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.27,
              "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": 14.27,
              "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": 12.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 14.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.27,
              "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": 14.27,
              "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": 11.7
            },
            {
              "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": 14.27,
              "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": 11.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 14.27,
              "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": 11.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.42
            },
            {
              "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": 9.02
            },
            {
              "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": 12.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.27,
              "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": 12.13
            },
            {
              "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": 7.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.83
            },
            {
              "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": 14.27,
              "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": 12.13
            },
            {
              "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": 9.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 14.27,
              "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": 14.27,
              "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": 9.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.42
            },
            {
              "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": 14.27,
              "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": 9.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.85
            },
            {
              "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": 14.27,
              "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": 12.13
            },
            {
              "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": 14.27,
              "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": 12.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.16
            },
            {
              "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": 9.29
            },
            {
              "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": 14.27,
              "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": 14.27,
              "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": 7.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.16
            },
            {
              "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": 11.7
            },
            {
              "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": 7.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.7
            },
            {
              "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": 9.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 14.27,
              "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": 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": 10.42
            },
            {
              "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": 14.27,
              "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": 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": 11.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.42
            },
            {
              "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": 14.27,
              "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": 9.29
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.13
            },
            {
              "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": 14.27,
              "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": 7.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.13
            },
            {
              "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": 14.27,
              "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": 14.27,
              "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": 14.27,
              "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": 11.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.02
            },
            {
              "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": 12.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.27,
              "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": 14.27,
              "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": 14.27,
              "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": 3.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.42
            },
            {
              "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": 9.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.13
            },
            {
              "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": 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": 7.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.85
            },
            {
              "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": 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": 7.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14.27,
              "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": 9.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.16
            },
            {
              "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": 12.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.27,
              "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": 14.27,
              "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": 14.27,
              "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": 14.27,
              "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": 14.27,
              "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": 14.27,
              "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": 12.13
            },
            {
              "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": 9.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.54
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.13
            },
            {
              "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": 14.27,
              "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": 11.83
            }
          ]
        }
      ]
    },
    {
      "description": "Lactogen Placental Sendout",
      "code_information": [
        {
          "code": "PX-30100309",
          "type": "CDM"
        },
        {
          "code": "83632",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 405,
          "discounted_cash": 263.25,
          "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": 260.01
            },
            {
              "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": 263.66
            },
            {
              "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": 405,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "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": 224.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 295.65
            },
            {
              "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": 295.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 332.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 255.96
            },
            {
              "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": 255.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 222.75
            },
            {
              "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": 263.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 263.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "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": 263.25
            },
            {
              "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": 260.01
            },
            {
              "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": 260.01
            },
            {
              "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": 332.1
            },
            {
              "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": 327.65
            },
            {
              "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": 355.19
            },
            {
              "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": 356.4
            },
            {
              "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": 255.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 255.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "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": 260.01
            },
            {
              "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": 224.78
            },
            {
              "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": 335.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 222.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 295.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 332.1
            },
            {
              "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": 110.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 222.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 255.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 332.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 303.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 303.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "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": 405,
              "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": 295.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 222.75
            },
            {
              "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": 332.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 224.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.78,
              "estimated_amount": 28.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 263.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 295.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 405
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 355.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 260.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 327.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 295.65
            },
            {
              "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": 260.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 255.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 303.75
            },
            {
              "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": 255.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 260.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 332.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 222.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 335.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 260.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 332.1
            },
            {
              "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": 344.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "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": 344.25
            },
            {
              "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": 260.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 260.01
            },
            {
              "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": 332.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.83,
              "estimated_amount": 75.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 344.25
            },
            {
              "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": 405,
              "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": 335.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 28.78,
              "estimated_amount": 28.78
            },
            {
              "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": 222.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 222.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 260.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 263.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 255.96
            },
            {
              "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": 224.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 260.01
            }
          ],
          "minimum": 28.78,
          "maximum": 75.83
        }
      ]
    },
    {
      "description": "HC Cholesterol Ldl Direct",
      "code_information": [
        {
          "code": "PX-30100323",
          "type": "CDM"
        },
        {
          "code": "83721",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 77,
          "discounted_cash": 50.05,
          "minimum": 7.83,
          "maximum": 39.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "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": 34.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.93,
              "estimated_amount": 13.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "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": 34.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.93,
              "estimated_amount": 13.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "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": 50.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.61,
              "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": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "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": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.03,
              "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": 42.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.61,
              "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": 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": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 50,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.93,
              "estimated_amount": 13.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.5,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.83,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "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": 38.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.5,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.03,
              "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": 77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "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": 65.45
            },
            {
              "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": 63.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.83,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.75
            },
            {
              "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": 19.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "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": 63.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.83,
              "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": 56.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.5,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.5,
              "estimated_amount": 10.5
            },
            {
              "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": 63.14
            },
            {
              "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": 42.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "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": 67.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "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": 65.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.5,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.5,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "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": 63.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.45
            },
            {
              "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": 77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.5,
              "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": 65.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.83,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 10.5,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.03,
              "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": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 34.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.38,
              "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": 56.21
            },
            {
              "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": 65.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Prealbumin",
      "code_information": [
        {
          "code": "PX-30100375",
          "type": "CDM"
        },
        {
          "code": "84134",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 89,
          "discounted_cash": 57.85,
          "minimum": 12.51,
          "maximum": 54.71,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.59,
              "estimated_amount": 14.59
            },
            {
              "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": 57.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.32,
              "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": 14.59,
              "estimated_amount": 14.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.59,
              "estimated_amount": 14.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "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": 89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "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": 75.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "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": 44.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.59,
              "estimated_amount": 14.59
            },
            {
              "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": 40.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.32,
              "estimated_amount": 21.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.74,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "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": 72.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.74,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "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": 89,
              "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": 48.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.59,
              "estimated_amount": 14.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.32,
              "estimated_amount": 21.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.97
            },
            {
              "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": 40.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "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": 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": 72.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.59,
              "estimated_amount": 14.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 40.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.59,
              "estimated_amount": 14.59
            },
            {
              "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": 72.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "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": 72.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "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": 78.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.74,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "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": 48.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.75
            },
            {
              "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": 40.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.74,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.32,
              "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": 75.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 44.5
            },
            {
              "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": 22.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.95
            },
            {
              "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": 89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.32,
              "estimated_amount": 21.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 89
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.51,
              "estimated_amount": 12.51
            },
            {
              "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": 64.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.71,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.65
            },
            {
              "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": 75.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.78,
              "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": 73.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 14.59,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.74,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sulfhemoglobin Blood Quant So",
      "code_information": [
        {
          "code": "PX-30101235",
          "type": "CDM"
        },
        {
          "code": "83060",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 82,
          "discounted_cash": 53.3,
          "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": 52.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 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": 45.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.89,
              "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": 59.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.82
            },
            {
              "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": 71.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "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": 52.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 53.38
            },
            {
              "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": 69.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 66.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "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": 82,
              "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": 45.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 67.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 67.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 61.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.64
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.24,
              "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": 22.39
            },
            {
              "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": 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": 51.82
            },
            {
              "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": 67.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "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": 82,
              "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": 52.64
            },
            {
              "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": 45.51
            },
            {
              "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": 52.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 67.24
            },
            {
              "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": 67.24
            },
            {
              "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": 69.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "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": 67.98
            },
            {
              "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": 51.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 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": 59.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.89,
              "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": 52.64
            },
            {
              "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": 72.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.89,
              "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": 52.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 53.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.64
            },
            {
              "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": 53.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "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": 53.38
            },
            {
              "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": 51.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.77,
              "estimated_amount": 11.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 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": 52.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 61.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.24,
              "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": 8.8,
              "estimated_amount": 8.8
            },
            {
              "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": 82,
              "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": 69.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "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": 71.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.77,
              "estimated_amount": 11.77
            },
            {
              "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": 52.64
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.89,
              "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": 52.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "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": 45.51
            },
            {
              "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": 66.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 61.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33,
              "estimated_amount": 33
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.77,
              "estimated_amount": 11.77
            },
            {
              "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": 67.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 67.24
            },
            {
              "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": 45.1
            },
            {
              "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": 51.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 8.8,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.89,
              "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": 53.38
            }
          ],
          "minimum": 8.8,
          "maximum": 33
        }
      ]
    },
    {
      "description": "HC Antidepressants Class; 3-5 So",
      "code_information": [
        {
          "code": "PX-30101241",
          "type": "CDM"
        },
        {
          "code": "80333",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 326,
          "discounted_cash": 211.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 203.75
            },
            {
              "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": 277.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 326,
              "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": 326,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.25,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.25,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 244.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 163
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 146.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 203.75
            },
            {
              "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": 203.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 267.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 163
            },
            {
              "payer_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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 203.75
            },
            {
              "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": 267.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 237.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 163
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 326,
              "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": 326,
              "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": 179.3
            },
            {
              "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": 146.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 179.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 203.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 146.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 203.75
            },
            {
              "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": 163
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.25,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "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": 267.32
            },
            {
              "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": 211.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.3
            },
            {
              "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": 326,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 163
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 244.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 277.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "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": 326,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 163
            },
            {
              "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": 203.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 163
            },
            {
              "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": 146.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 237.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 237.98
            },
            {
              "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": 326,
              "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": 277.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 277.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 326
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 326,
              "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": 50,
              "estimated_amount": 163
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.85,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 237.98
            },
            {
              "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": 62.5,
              "estimated_amount": 203.75
            },
            {
              "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": 203.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 146.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 244.5
            },
            {
              "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": 179.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 237.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.25,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 163
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 237.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 203.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 146.7
            },
            {
              "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": 146.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 146.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 146.7
            },
            {
              "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": 286.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 163
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 203.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 326,
              "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": 62.5,
              "estimated_amount": 203.75
            },
            {
              "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": 81.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 146.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.1
            }
          ],
          "minimum": 10.25,
          "maximum": 12.85
        }
      ]
    },
    {
      "description": "Cyp2c9 Sequence Genotype Sendout",
      "code_information": [
        {
          "code": "PX-30100556",
          "type": "CDM"
        },
        {
          "code": "81227",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1825,
          "discounted_cash": 1186.25,
          "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": 1171.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1171.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1476.43
            },
            {
              "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": 1496.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 183.55,
              "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": 1606
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1153.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1003.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1003.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1171.65
            },
            {
              "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": 1153.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "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": 1012.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.67,
              "estimated_amount": 152.67
            },
            {
              "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": 1600.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "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": 1171.65
            },
            {
              "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": 1171.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 174.81,
              "estimated_amount": 174.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "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": 1332.25
            },
            {
              "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": 1825,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 176.56,
              "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": 1012.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1003.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1171.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1171.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1332.25
            },
            {
              "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": 1825,
              "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": 1186.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1003.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1496.5
            },
            {
              "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": 1003.75
            },
            {
              "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": 1551.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1188.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1368.75
            },
            {
              "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": 1512.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1153.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1332.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 183.55,
              "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": 1512.93
            },
            {
              "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": 1600.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1171.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 176.56,
              "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": 1496.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1496.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1496.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1332.25
            },
            {
              "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": 1153.4
            },
            {
              "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": 1476.43
            },
            {
              "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": 1153.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1368.75
            },
            {
              "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": 1551.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 174.81,
              "estimated_amount": 174.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 174.81,
              "estimated_amount": 174.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1003.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1512.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "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": 1171.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 152.67,
              "estimated_amount": 152.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1153.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1003.75
            },
            {
              "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": 1496.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 176.56,
              "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": 174.81,
              "estimated_amount": 174.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1012.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 174.81,
              "estimated_amount": 174.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1153.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1188.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "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": 1012.88
            },
            {
              "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": 1171.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "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": 399.68
            },
            {
              "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": 1171.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1171.65
            },
            {
              "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": 1496.5
            },
            {
              "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": 498.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 176.56,
              "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": 1551.25
            },
            {
              "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": 1825,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "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": 1188.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1332.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 176.56,
              "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": 1188.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1825
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1496.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 655.54,
              "estimated_amount": 655.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 174.81,
              "estimated_amount": 174.81
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 174.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 183.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 174.81,
              "estimated_amount": 174.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1153.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1332.25
            },
            {
              "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": 1188.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1551.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1368.75
            }
          ],
          "minimum": 152.67,
          "maximum": 655.54
        }
      ]
    },
    {
      "description": "Shampoo No-Rinse 8 Oz",
      "code_information": [
        {
          "code": "PX-CH-PH11150-008",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.21,
          "discounted_cash": 2.09,
          "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": 2.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.73
            },
            {
              "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": 2.03
            },
            {
              "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": 3.21,
              "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": 3.21,
              "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": 2.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.09
            },
            {
              "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": 2.63
            },
            {
              "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": 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": 2.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 2.06
            },
            {
              "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": 0.88
            },
            {
              "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": 2.03
            },
            {
              "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": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.06
            },
            {
              "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": 2.06
            },
            {
              "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": 2.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 1.77
            },
            {
              "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": 2.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.41
            },
            {
              "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": 2.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 1.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.66
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.77
            },
            {
              "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": 2.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 2.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 2.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 2.09
            },
            {
              "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": 2.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.77
            },
            {
              "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": 1.78
            },
            {
              "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": 2.73
            },
            {
              "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": 2.06
            },
            {
              "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": 2.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.03
            },
            {
              "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": 3.21,
              "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": 3.21,
              "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": 3.21,
              "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": 2.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 3.21,
              "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": 2.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.77
            },
            {
              "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": 2.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 1.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 1.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 2.82
            },
            {
              "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": 2.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 3.21,
              "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": 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": 2.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 2.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 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": 2.63
            },
            {
              "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": 2.63
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 2.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.21,
              "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": 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": 2.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 2.09
            },
            {
              "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": 2.6
            }
          ]
        }
      ]
    },
    {
      "description": "Gloves Nitrile Powder-Free Medium Ambitex",
      "code_information": [
        {
          "code": "PX-CH-IMCAXNMD400",
          "type": "CDM"
        },
        {
          "code": "A4927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.17,
          "discounted_cash": 0.11,
          "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": 0.11
            },
            {
              "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": 0.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 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": 0.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.17
            },
            {
              "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": 0.17,
              "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": 0.17,
              "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": 0.14
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.14
            },
            {
              "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": 0.17,
              "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": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.17,
              "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": 0.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.14
            },
            {
              "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": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.17,
              "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": 0.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.09
            },
            {
              "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": 0.14
            },
            {
              "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": 0.17,
              "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": 0.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.14
            },
            {
              "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": 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": 0.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.12
            },
            {
              "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": 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": 0.14
            },
            {
              "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": 0.17,
              "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": 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": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.17,
              "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": 0.17,
              "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": 0.17,
              "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": 0.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.11
            },
            {
              "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": 0.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 0.09
            },
            {
              "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": 0.05
            },
            {
              "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": 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": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 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": 0.17,
              "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": 0.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.12
            },
            {
              "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": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.14
            },
            {
              "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": 0.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.11
            },
            {
              "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": 0.17,
              "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": 0.17,
              "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": 0.17,
              "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": 0.17,
              "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": 0.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.15
            },
            {
              "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": 0.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.17,
              "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": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.14
            }
          ]
        }
      ]
    },
    {
      "description": "HC Direct O2 Saturation",
      "code_information": [
        {
          "code": "PX-30100693",
          "type": "CDM"
        },
        {
          "code": "82810",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 155,
          "discounted_cash": 100.75,
          "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": 99.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.51
            },
            {
              "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": 127.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.26,
              "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": 85.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.77,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 97.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "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": 99.51
            },
            {
              "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": 86.03
            },
            {
              "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": 128.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 97.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.25
            },
            {
              "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": 155,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "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": 42.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.51
            },
            {
              "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": 127.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.77,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.77,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.87,
              "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": 116.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.87,
              "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": 131.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.87,
              "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": 128.5
            },
            {
              "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": 131.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.25
            },
            {
              "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": 113.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.87,
              "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": 131.75
            },
            {
              "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": 125.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 97.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 125.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "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": 86.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 116.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 155
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 116.25
            },
            {
              "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": 135.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "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": 155,
              "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": 97.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "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": 97.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.77,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.77,
              "estimated_amount": 9.77
            },
            {
              "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": 99.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 128.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.26,
              "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": 113.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 10.26,
              "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": 127.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.1
            },
            {
              "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": 97.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 9.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.71,
              "estimated_amount": 9.71
            },
            {
              "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": 135.94
            },
            {
              "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": 127.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.75
            },
            {
              "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": 136.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.1
            },
            {
              "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": 100.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 97.96
            },
            {
              "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": 100.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.15
            },
            {
              "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": 155,
              "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": 100.91
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.77,
              "estimated_amount": 9.77
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.77,
              "estimated_amount": 9.77
            },
            {
              "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": 99.51
            },
            {
              "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": 97.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.64,
              "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": 99.51
            },
            {
              "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": 86.03
            }
          ],
          "minimum": 9.71,
          "maximum": 36.64
        }
      ]
    },
    {
      "description": "HC Hexosaminidase Total Serum",
      "code_information": [
        {
          "code": "PX-30100706",
          "type": "CDM"
        },
        {
          "code": "83080",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 749,
          "discounted_cash": 486.85,
          "minimum": 5.76,
          "maximum": 63.26,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 614.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 561.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 411.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 411.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 546.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.84,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 614.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 411.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 561.75
            },
            {
              "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": 486.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "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": 636.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.84,
              "estimated_amount": 19.84
            },
            {
              "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": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 546.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 614.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 411.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 546.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 749
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 614.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 659.12
            },
            {
              "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": 614.18
            },
            {
              "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": 546.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "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": 411.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 546.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 546.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 561.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 614.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "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": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "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": 411.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 749,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 16.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 17.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "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": 636.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 411.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.87,
              "estimated_amount": 16.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.47,
              "estimated_amount": 14.47
            },
            {
              "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": 187.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24,
              "estimated_amount": 24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 636.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 614.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 63.26,
              "estimated_amount": 63.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.76,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.88,
              "estimated_amount": 21.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 614.18
            }
          ]
        }
      ]
    },
    {
      "description": "HC Oxalate So",
      "code_information": [
        {
          "code": "PX-30100838",
          "type": "CDM"
        },
        {
          "code": "83945",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 147,
          "discounted_cash": 95.55,
          "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": 94.37
            },
            {
              "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": 40.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.45,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.59,
              "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": 147,
              "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": 128.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "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": 120.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "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": 92.9
            },
            {
              "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": 128.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.45,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.86
            },
            {
              "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": 124.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "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": 94.37
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.45,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.45,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "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": 80.85
            },
            {
              "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": 107.31
            },
            {
              "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": 124.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "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": 81.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "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": 147,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.45,
              "estimated_amount": 14.45
            },
            {
              "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": 129.36
            },
            {
              "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": 120.54
            },
            {
              "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": 81.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "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": 95.7
            },
            {
              "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": 92.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "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": 94.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.82,
              "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": 92.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "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": 118.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.7
            },
            {
              "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": 121.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.59,
              "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": 94.37
            },
            {
              "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": 94.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "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": 124.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 147
            },
            {
              "payer_name": "UHC 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.45,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.7
            },
            {
              "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": 120.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.59,
              "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": 81.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "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": 81.59
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.59,
              "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": 124.95
            },
            {
              "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": 95.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "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": 95.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.45,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.54
            },
            {
              "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": 92.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 54.19,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 118.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 124.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 14.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 14.45,
          "maximum": 54.19
        }
      ]
    },
    {
      "description": "HC Cardiolipin Antibody Ea Ig Class",
      "code_information": [
        {
          "code": "PX-30200014",
          "type": "CDM"
        },
        {
          "code": "86147",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 135,
          "discounted_cash": 87.75,
          "minimum": 16.45,
          "maximum": 95.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 101.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "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": 67.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.25
            },
            {
              "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": 98.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.72,
              "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": 114.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "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": 45,
              "estimated_amount": 60.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 60.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 67.5
            },
            {
              "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": 87.75
            },
            {
              "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": 33.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 110.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.83,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 60.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 60.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "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": 74.25
            },
            {
              "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": 114.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 60.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.72,
              "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": 67.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.83,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 101.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "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": 114.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "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": 110.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 26.72,
              "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": 135
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 67.5
            },
            {
              "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": 135,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "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": 118.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 101.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 110.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.83,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "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": 114.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "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": 45,
              "estimated_amount": 60.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 67.5
            },
            {
              "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": 110.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "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": 114.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 110.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 110.7
            },
            {
              "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": 135,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "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": 60.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 60.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 25.45,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 25.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 98.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 95.44,
              "estimated_amount": 95.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            },
            {
              "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": 135,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.45,
              "estimated_amount": 25.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.45,
              "estimated_amount": 16.45
            },
            {
              "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": 67.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 110.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 60.75
            },
            {
              "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": 110.7
            },
            {
              "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": 60.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 34.83,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 114.75
            }
          ]
        }
      ]
    },
    {
      "description": "Ca 125 Sendout",
      "code_information": [
        {
          "code": "PX-30200031",
          "type": "CDM"
        },
        {
          "code": "86304",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39,
          "discounted_cash": 25.35,
          "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": 25.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "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": 39,
              "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": 33.15
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 25.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.85,
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "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": 32.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "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": 10.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 21.45
            },
            {
              "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": 33.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "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": 25.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 33.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "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": 21.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 25.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.85,
              "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": 31.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.45
            },
            {
              "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": 24.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 29.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 25.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.02,
              "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": 33.15
            },
            {
              "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": 25.35
            },
            {
              "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": 21.65
            },
            {
              "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": 34.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "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": 33.15
            },
            {
              "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": 28.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.65
            },
            {
              "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": 39,
              "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": 24.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 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": 31.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "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": 34.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "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": 25.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 20.81,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 21.85,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "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": 21.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 78.04,
              "estimated_amount": 78.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.39
            },
            {
              "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": 31.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "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": 24.65
            },
            {
              "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": 39,
              "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": 25.04
            },
            {
              "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": 21.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            },
            {
              "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": 34.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.81,
              "estimated_amount": 20.81
            }
          ],
          "minimum": 20.81,
          "maximum": 78.04
        }
      ]
    },
    {
      "description": "1 Pc Pre- Cut Cvx 1-1/8 Pre Cut Maxi",
      "code_information": [
        {
          "code": "PX-CH-CO16742",
          "type": "CDM"
        },
        {
          "code": "A4389",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.53,
          "discounted_cash": 5.54,
          "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": 5.48
            },
            {
              "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": 8.53,
              "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": 7.48
            },
            {
              "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": 7.07
            },
            {
              "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": 7.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 8.53,
              "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": 7.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 8.53,
              "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": 4.69
            },
            {
              "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": 8.53,
              "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": 8.53,
              "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": 7.25
            },
            {
              "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": 7.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.48
            },
            {
              "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": 5.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 8.53,
              "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": 8.53,
              "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": 8.53,
              "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": 8.53,
              "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": 7.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.23
            },
            {
              "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": 8.53,
              "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": 4.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.55
            },
            {
              "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": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 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": 5.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 6.99
            },
            {
              "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": 6.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.99
            },
            {
              "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": 8.53,
              "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": 8.53,
              "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": 7.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.25
            },
            {
              "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": 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": 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": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 8.53,
              "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": 6.9
            },
            {
              "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": 8.53,
              "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": 8.53,
              "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": 5.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 8.53,
              "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": 4.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.39
            },
            {
              "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": 5.48
            },
            {
              "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": 5.48
            },
            {
              "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": 8.53,
              "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": 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": 7.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.48
            },
            {
              "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": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 8.53,
              "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": 8.53,
              "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": 8.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.39
            },
            {
              "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": 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": 6.99
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.53,
              "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": 6.23
            },
            {
              "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": 8.53,
              "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": 8.53,
              "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": 8.53,
              "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": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 6.23
            },
            {
              "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": 6.9
            },
            {
              "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": 2.33
            },
            {
              "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": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 4.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 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": 5.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.53,
              "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": 8.53,
              "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": 8.53,
              "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": 8.53,
              "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": 8.53,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Diphtheria Antibody",
      "code_information": [
        {
          "code": "PX-30200087",
          "type": "CDM"
        },
        {
          "code": "86648",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 145,
          "discounted_cash": 94.25,
          "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": 93.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "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": 94.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "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": 105.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.09,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.09,
              "estimated_amount": 20.09
            },
            {
              "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": 118.9
            },
            {
              "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": 127.17
            },
            {
              "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": 39.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 145,
              "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": 145,
              "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": 117.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "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": 80.48
            },
            {
              "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": 80.48
            },
            {
              "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": 123.25
            },
            {
              "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": 118.9
            },
            {
              "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": 127.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "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": 91.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "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": 91.64
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 80.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "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": 94.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 118.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 145
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "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": 127.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 120.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "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": 79.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 94.4
            },
            {
              "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": 123.25
            },
            {
              "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": 80.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 123.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 117.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 91.64
            },
            {
              "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": 93.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            },
            {
              "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": 145,
              "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": 79.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 79.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 120.21
            },
            {
              "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": 120.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 118.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 108.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 93.09
            },
            {
              "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": 94.4
            },
            {
              "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": 91.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.04,
              "estimated_amount": 57.04
            }
          ],
          "minimum": 20.09,
          "maximum": 57.04
        }
      ]
    },
    {
      "description": "Hiv 2 Antibody Sendout",
      "code_information": [
        {
          "code": "PX-30200110",
          "type": "CDM"
        },
        {
          "code": "86702",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 104,
          "discounted_cash": 67.6,
          "minimum": 11.6,
          "maximum": 50.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "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": 104,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.6,
              "estimated_amount": 11.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.76,
              "estimated_amount": 19.76
            },
            {
              "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": 57.2
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.6,
              "estimated_amount": 11.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 104,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 104,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "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": 85.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "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": 88.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.2,
              "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": 91.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "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": 88.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.76,
              "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": 57.2
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "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": 75.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 104,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "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": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.76,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 104,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 104,
              "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": 104,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "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": "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": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.6,
              "estimated_amount": 11.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "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": 85.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 14.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.93,
              "estimated_amount": 18.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.91,
              "estimated_amount": 15.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 13.52,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.66,
              "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": 85.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "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": 104,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "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": 67.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "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": "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": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.91,
              "estimated_amount": 15.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.52,
              "estimated_amount": 13.52
            },
            {
              "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": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.7,
              "estimated_amount": 50.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.6,
              "estimated_amount": 11.6
            },
            {
              "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": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 25,
              "estimated_amount": 26
            }
          ]
        }
      ]
    },
    {
      "description": "Parvovirus Antibody Sendout",
      "code_information": [
        {
          "code": "PX-30200126",
          "type": "CDM"
        },
        {
          "code": "86747",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 54,
          "discounted_cash": 35.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "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 MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.03,
              "estimated_amount": 15.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.18,
              "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": 54,
              "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": 35.15
            },
            {
              "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": "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": "AETNA [310]",
              "plan_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 OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.78,
              "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": 44.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.96,
              "estimated_amount": 21.96
            },
            {
              "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 HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "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": 44.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "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": 54,
              "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": 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": "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 HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.96,
              "estimated_amount": 21.96
            },
            {
              "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.78,
              "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": 45.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.78,
              "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": 40.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "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 OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "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": 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": "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": "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": "AETNA [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": "AVALON HEALTHREACH OH [540410]",
              "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": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.03,
              "estimated_amount": 15.03
            },
            {
              "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": 47.52
            },
            {
              "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": 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": "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": "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": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.03,
              "estimated_amount": 15.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.03,
              "estimated_amount": 15.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.03,
              "estimated_amount": 15.03
            },
            {
              "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 POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "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": 44.28
            },
            {
              "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": "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": "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.18,
              "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": 45.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.03,
              "estimated_amount": 15.03
            },
            {
              "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": 34.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "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": 39.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "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": 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": "HUMANA [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": "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": "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": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "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": 14.74
            },
            {
              "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": "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": "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": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 56.36,
              "estimated_amount": 56.36
            },
            {
              "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": "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": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 15.03,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.96,
              "estimated_amount": 21.96
            },
            {
              "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": 29.97
            },
            {
              "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": 34.67
            },
            {
              "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": 47.36
            },
            {
              "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": 47.36
            },
            {
              "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.03,
              "estimated_amount": 15.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.77
            }
          ],
          "minimum": 15.03,
          "maximum": 56.36
        }
      ]
    },
    {
      "description": "HC Indirect Coombs Ea Antibody Titer",
      "code_information": [
        {
          "code": "PX-30200157",
          "type": "CDM"
        },
        {
          "code": "86886",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 673,
          "discounted_cash": 437.45,
          "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": 432.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 438.12
            },
            {
              "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": 491.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 425.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 551.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 504.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 673
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 145.92,
              "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": 557.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 425.34
            },
            {
              "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": 425.34
            },
            {
              "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": 148.9,
              "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": 432.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 432.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 438.12
            },
            {
              "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": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 373.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.56,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 491.29
            },
            {
              "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": 572.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 551.86
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "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": 437.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 432.07
            },
            {
              "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": 432.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 432.07
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "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": 150.57,
              "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": 432.07
            },
            {
              "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": 551.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 370.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 370.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 491.29
            },
            {
              "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": 150.57,
              "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": 425.34
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 557.92
            },
            {
              "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": 544.46
            },
            {
              "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": 551.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 425.34
            },
            {
              "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": 590.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "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": 373.52
            },
            {
              "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": 150.57,
              "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": 425.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "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": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.9,
              "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": 572.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 491.29
            },
            {
              "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": 373.52
            },
            {
              "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": 557.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 491.29
            },
            {
              "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": 150.57,
              "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": 156.53,
              "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": 673,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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 CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 504.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 551.86
            },
            {
              "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": 551.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 551.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.56,
              "estimated_amount": 7.56
            },
            {
              "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": 432.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 438.12
            },
            {
              "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": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 183.73
            },
            {
              "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": 425.34
            },
            {
              "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": 148.9,
              "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": 150.57,
              "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": 572.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 373.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 673,
              "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": 432.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 432.07
            },
            {
              "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": 438.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 370.15
            },
            {
              "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": 156.53,
              "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": 370.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "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": 7.56,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "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": 592.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 370.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 491.29
            },
            {
              "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": 145.92,
              "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": 370.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 370.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 572.05
            },
            {
              "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": 572.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 504.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 551.86
            },
            {
              "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": 145.92,
              "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": 673,
              "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": 432.07
            },
            {
              "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": 438.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 544.46
            },
            {
              "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": 153.22,
              "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": 425.34
            },
            {
              "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": 590.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 432.07
            },
            {
              "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": 145.92,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 7.56,
          "maximum": 19.43
        }
      ]
    },
    {
      "description": "HC Platelet Antibody",
      "code_information": [
        {
          "code": "PX-30200350",
          "type": "CDM"
        },
        {
          "code": "86022",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 722,
          "discounted_cash": 469.3,
          "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": 463.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 463.52
            },
            {
              "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": 613.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 592.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.29,
              "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": 584.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 592.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 456.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 463.52
            },
            {
              "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": 592.04
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "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": 592.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 527.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.55,
              "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": 470.02
            },
            {
              "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": 592.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 397.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 397.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "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": 469.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.55,
              "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": 397.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 527.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 527.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "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": 456.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "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": 463.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.29,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 463.52
            },
            {
              "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": 463.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 470.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 722
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "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": 397.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.55,
              "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": 613.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 456.3
            },
            {
              "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": 456.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 456.3
            },
            {
              "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": 633.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 592.04
            },
            {
              "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": 527.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 19.29,
              "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": 456.3
            },
            {
              "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": 456.3
            },
            {
              "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": 400.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 541.5
            },
            {
              "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": 470.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 598.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 470.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.84,
              "estimated_amount": 26.84
            },
            {
              "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": 613.7
            },
            {
              "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": 722,
              "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": 463.52
            },
            {
              "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": 197.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 527.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "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": 400.71
            },
            {
              "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": 400.71
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "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": 613.7
            },
            {
              "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": 722,
              "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": 541.5
            },
            {
              "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": 470.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 613.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 463.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 463.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 592.04
            },
            {
              "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": 635.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 397.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 598.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 541.5
            },
            {
              "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": 598.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 592.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 584.1
            },
            {
              "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": 463.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 400.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 68.89,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 527.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "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": 397.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 18.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.55,
              "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": 463.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 456.3
            },
            {
              "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": 722,
              "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": 633.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 397.1
            },
            {
              "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": 463.52
            }
          ],
          "minimum": 18.37,
          "maximum": 68.89
        }
      ]
    },
    {
      "description": "HC Ena Screen Ssa/B Sm Rnp Scl70 Jo1",
      "code_information": [
        {
          "code": "PX-30200371",
          "type": "CDM"
        },
        {
          "code": "86235",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 183,
          "discounted_cash": 118.95,
          "minimum": 15.39,
          "maximum": 67.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.2,
              "estimated_amount": 26.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.93,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.93,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "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": 150.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "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": 183,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.2,
              "estimated_amount": 26.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 45,
              "estimated_amount": 82.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.93,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "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": 183,
              "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": 100.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.83,
              "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": 155.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 91.5
            },
            {
              "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": 150.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "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": 150.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.39,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.11,
              "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": 183
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "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": 82.35
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.83,
              "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": 155.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.11,
              "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": 50,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "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": 155.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 82.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 91.5
            },
            {
              "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": 91.5
            },
            {
              "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": 82.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 82.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "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": 82.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 82.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.2,
              "estimated_amount": 26.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.39,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.39,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "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": 118.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.39,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "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": 155.55
            },
            {
              "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": 161.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 150.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 82.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 155.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.83,
              "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": 17.93,
              "estimated_amount": 17.93
            },
            {
              "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": 100.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.93,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 82.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 82.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "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": 183,
              "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": 50,
              "estimated_amount": 91.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 133.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 17.93,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 18.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.93,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.79,
              "estimated_amount": 19.79
            },
            {
              "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": 45.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.93,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 67.24,
              "estimated_amount": 67.24
            },
            {
              "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": 133.59
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Non-Adhesive Copa 4 in X 8 In",
      "code_information": [
        {
          "code": "PX-CH-KN1694-NX",
          "type": "CDM"
        },
        {
          "code": "A6210",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.68,
          "discounted_cash": 3.04,
          "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
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.68,
              "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": 2.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 3.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 3.42
            },
            {
              "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": 4.1
            },
            {
              "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": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 4.68,
              "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": 3.84
            },
            {
              "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": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 4.68,
              "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": 3.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "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": 3.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 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
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 3.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.42
            },
            {
              "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": 2.96
            },
            {
              "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": 2.96
            },
            {
              "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": 4.68,
              "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": 2.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 2.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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
            },
            {
              "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
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.96
            },
            {
              "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": 3.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 4.68,
              "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": 3.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.05
            },
            {
              "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": 4.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 4.68,
              "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": 4.68,
              "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": 3.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.57
            },
            {
              "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": 4.68,
              "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": 4.68,
              "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": 4.68,
              "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": 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": 3.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.96
            },
            {
              "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": 4.68,
              "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
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 2.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 4.68,
              "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": 4.68,
              "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": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 2.6
            },
            {
              "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": 3.98
            },
            {
              "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": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 3.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.68,
              "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": 3.84
            },
            {
              "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": 4.68,
              "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": 2.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.68,
              "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": 3.51
            },
            {
              "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": 3.84
            },
            {
              "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": 4.68,
              "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": 4.68,
              "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": 3.84
            },
            {
              "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": 4.68,
              "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": 4.68,
              "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": 4.68,
              "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": 3.88
            },
            {
              "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": 4.68,
              "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
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.05
            },
            {
              "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": 4.68,
              "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": 2.57
            },
            {
              "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": 4.68,
              "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
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.79
            },
            {
              "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": 3.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.98
            },
            {
              "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": 4.68,
              "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": 4.68,
              "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": 4.68,
              "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": 3.79
            }
          ]
        }
      ]
    },
    {
      "description": "HC Cell Count Manual Each",
      "code_information": [
        {
          "code": "PX-30500009",
          "type": "CDM"
        },
        {
          "code": "85032",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 109,
          "discounted_cash": 70.85,
          "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": 69.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "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": 60.5
            },
            {
              "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": 60.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "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": 70.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.38
            },
            {
              "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": 109,
              "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": 69.98
            },
            {
              "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": 70.96
            },
            {
              "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": 89.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 109
            },
            {
              "payer_name": "UHC 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,
              "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": 68.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "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": 70.85
            },
            {
              "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": 79.57
            },
            {
              "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": 69.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "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": 109,
              "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": 69.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.57
            },
            {
              "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": 60.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.35,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.98
            },
            {
              "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": 88.18
            },
            {
              "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": 68.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.38
            },
            {
              "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": 69.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "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": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "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": 95.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.98
            },
            {
              "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": 59.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 88.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.89
            },
            {
              "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": 89.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.75
            },
            {
              "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": 95.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.35,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.96
            },
            {
              "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": 89.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.98
            },
            {
              "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": 29.76
            },
            {
              "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": 92.65
            },
            {
              "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": 68.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "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": 90.36
            },
            {
              "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": 92.65
            },
            {
              "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": 95.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 69.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.57
            },
            {
              "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": 69.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.95
            }
          ],
          "minimum": 6.35,
          "maximum": 16.16
        }
      ]
    },
    {
      "description": "HC Protein S Antigen Free Total",
      "code_information": [
        {
          "code": "PX-30500039",
          "type": "CDM"
        },
        {
          "code": "85306",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 800,
          "discounted_cash": 520,
          "minimum": 13.15,
          "maximum": 57.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 400
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 440
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 584
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 584
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 360
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 360
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 600
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.39,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 400
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "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": 360
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 600
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 440
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.47,
              "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": 400
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "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": 800,
              "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": 584
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 584
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 440
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 360
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "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": 680
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.15,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.32,
              "estimated_amount": 15.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.15,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 400
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 400
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 400
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.39,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.32,
              "estimated_amount": 15.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22.39,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.32,
              "estimated_amount": 15.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 440
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 800
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.32,
              "estimated_amount": 15.32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.32,
              "estimated_amount": 15.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.15,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "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": 360
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 440
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 440
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.47,
              "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": 600
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "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": 400
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 360
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "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": 45,
              "estimated_amount": 360
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 400
            },
            {
              "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": 200
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 520
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 704
            },
            {
              "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": 360
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 360
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 584
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.47,
              "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": 50,
              "estimated_amount": 400
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.32,
              "estimated_amount": 15.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 15.47,
              "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": 680
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.15,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 400
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 440
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 584
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57.45,
              "estimated_amount": 57.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.32,
              "estimated_amount": 15.32
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.67,
              "estimated_amount": 32.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 656
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 680
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 15.32,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "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": 45,
              "estimated_amount": 360
            }
          ]
        }
      ]
    },
    {
      "description": "HC Factor Inhibitor",
      "code_information": [
        {
          "code": "PX-30500041",
          "type": "CDM"
        },
        {
          "code": "85335",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1386,
          "discounted_cash": 900.9,
          "minimum": 11.05,
          "maximum": 48.26,
          "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": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.15,
              "estimated_amount": 15.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1386,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1136.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "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": 1136.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1011.78
            },
            {
              "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": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 762.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 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": 1178.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.05,
              "estimated_amount": 11.05
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1136.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1136.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1386,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.51,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 762.3
            },
            {
              "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1039.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1039.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1136.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 1386,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 900.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 762.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1386
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "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": 1219.68
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.51,
              "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": 762.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1011.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.05,
              "estimated_amount": 11.05
            },
            {
              "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": 303.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1136.52
            },
            {
              "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": 1011.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1136.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1386,
              "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": 762.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "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": 1178.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1386,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.05,
              "estimated_amount": 11.05
            },
            {
              "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": 1386,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.05,
              "estimated_amount": 11.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13,
              "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": 1178.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.15,
              "estimated_amount": 15.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1136.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.87,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "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": 762.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1386,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "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": 1178.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1011.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1011.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1386,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.71,
              "estimated_amount": 16.71
            },
            {
              "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": 346.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.26,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 12.87,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.51,
              "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": 762.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1011.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1039.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1178.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Worm Exam",
      "code_information": [
        {
          "code": "PX-30600131",
          "type": "CDM"
        },
        {
          "code": "87169",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 162,
          "discounted_cash": 105.3,
          "minimum": 3.67,
          "maximum": 16.16,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.01,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.1
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.08,
              "estimated_amount": 6.08
            },
            {
              "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": 137.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.08,
              "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": 89.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "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": 132.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.01,
              "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": 137.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 121.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "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": 132.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.84
            },
            {
              "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": 40.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 89.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 162,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "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": 118.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 162,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "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": 132.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.53,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.53,
              "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": 137.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 162
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.08,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 121.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 162,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "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": 162,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.53,
              "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": 142.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.84
            },
            {
              "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": 162,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 162,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.67,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 118.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 162,
              "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": 162,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 4.31,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "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": 105.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.55,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.3,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.31,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 121.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.16,
              "estimated_amount": 16.16
            }
          ]
        }
      ]
    },
    {
      "description": "HC Culture Viral Hsv",
      "code_information": [
        {
          "code": "PX-30600173",
          "type": "CDM"
        },
        {
          "code": "87255",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 356,
          "discounted_cash": 231.4,
          "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": 228.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.88
            },
            {
              "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": 224.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 267
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "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": 291.92
            },
            {
              "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": 291.92
            },
            {
              "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": 356,
              "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": 302.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "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": 231.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 197.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.55
            },
            {
              "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": 356,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 267
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "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": 302.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "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": 197.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.02,
              "estimated_amount": 50.02
            },
            {
              "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": 302.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.76
            },
            {
              "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": 231.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 295.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 295.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "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": 312.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.99
            },
            {
              "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": 197.58
            },
            {
              "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": 295.12
            },
            {
              "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": 259.88
            },
            {
              "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": 356,
              "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": 224.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.76
            },
            {
              "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": 288
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.99
            },
            {
              "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": 231.4
            },
            {
              "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": 197.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 288
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.55
            },
            {
              "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": 195.8
            },
            {
              "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": 224.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 356
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "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": 228.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "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": 97.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.8
            },
            {
              "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": 313.28
            },
            {
              "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": 291.92
            },
            {
              "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": 228.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.92
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 50.02,
              "estimated_amount": 50.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "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": 228.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 126.98,
              "estimated_amount": 126.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 267
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 312.21
            },
            {
              "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": 228.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.99
            }
          ],
          "minimum": 50.02,
          "maximum": 126.98
        }
      ]
    },
    {
      "description": "HC Mrsa Screen Probe",
      "code_information": [
        {
          "code": "PX-30600235",
          "type": "CDM"
        },
        {
          "code": "87641",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 627,
          "discounted_cash": 407.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "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": 402.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "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": 514.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "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": 532.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.85,
              "estimated_amount": 51.85
            },
            {
              "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": 396.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 470.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 551.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "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": 627,
              "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": 402.53
            },
            {
              "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": 347.99
            },
            {
              "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": 171.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "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": 627,
              "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": 408.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 396.26
            },
            {
              "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": 532.95
            },
            {
              "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": 549.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 402.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 470.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 347.99
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "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": 396.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 457.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "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": 519.78
            },
            {
              "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": 549.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.85,
              "estimated_amount": 51.85
            },
            {
              "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": 627,
              "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": 402.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "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": 402.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 408.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 396.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 408.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 347.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 519.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 396.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 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": 507.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 36.84,
              "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": 396.26
            },
            {
              "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": 396.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "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": 514.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 396.26
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 532.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "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": 457.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 35.09,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 35.44,
              "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": 532.95
            },
            {
              "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": 402.53
            },
            {
              "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": 408.18
            },
            {
              "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": 514.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 627
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 408.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 470.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "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": 344.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 519.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 51.85,
              "estimated_amount": 51.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 35.09,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 131.59,
              "estimated_amount": 131.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "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": 347.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 507.24
            }
          ],
          "minimum": 35.09,
          "maximum": 131.59
        }
      ]
    },
    {
      "description": "HC Gross Only Level I 1 Spec",
      "code_information": [
        {
          "code": "PX-31000037",
          "type": "CDM"
        },
        {
          "code": "88300",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 253,
          "discounted_cash": 164.45,
          "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": 162.43
            },
            {
              "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": 25.99,
              "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": 184.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26.25,
              "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": 221.88
            },
            {
              "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": 204.68
            },
            {
              "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": 221.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 253
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "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": 26.52,
              "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": 159.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.43
            },
            {
              "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": 140.42
            },
            {
              "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": 27.29,
              "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": 159.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.69
            },
            {
              "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": 159.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 209.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 253,
              "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": 215.05
            },
            {
              "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": 209.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.17,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.17,
              "estimated_amount": 7.17
            },
            {
              "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": 159.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 27.29,
              "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": 215.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 140.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "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": 139.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.69
            },
            {
              "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": 164.7
            },
            {
              "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": 140.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 189.75
            },
            {
              "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": 207.46
            },
            {
              "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": 25.99,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 209.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.69
            },
            {
              "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": 253,
              "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": 26.25,
              "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": 215.05
            },
            {
              "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": 26.52,
              "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": 189.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 139.15
            },
            {
              "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": 159.9
            },
            {
              "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": 162.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 140.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 204.68
            },
            {
              "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": 25.99,
              "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": 159.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "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": 253,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.17,
              "estimated_amount": 7.17
            },
            {
              "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": 162.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.46
            },
            {
              "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": 215.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 26.52,
              "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": 26.25,
              "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": 207.46
            },
            {
              "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": 26.25,
              "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": 159.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "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": 26.25,
              "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": 25.99,
              "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": 162.43
            },
            {
              "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": 162.43
            },
            {
              "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": 207.46
            },
            {
              "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": 164.45
            },
            {
              "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": 222.64
            },
            {
              "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": 162.43
            },
            {
              "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": 69.07
            },
            {
              "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": 164.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 215.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.43
            },
            {
              "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": 207.46
            },
            {
              "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": 27.29,
              "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": 189.75
            }
          ],
          "minimum": 7.17,
          "maximum": 93.6
        }
      ]
    },
    {
      "description": "HC Xr Mandible Complete 4 + Vw",
      "code_information": [
        {
          "code": "PX-32000005",
          "type": "CDM"
        },
        {
          "code": "70110",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 361,
          "discounted_cash": 234.65,
          "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": 231.76
            },
            {
              "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": 228.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 228.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 306.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 228.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 296.02
            },
            {
              "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": 95.95,
              "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": 198.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 198.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 361,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 306.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 306.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 198.55
            },
            {
              "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": 95.95,
              "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": 361,
              "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": 361,
              "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": 296.02
            },
            {
              "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": 296.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 231.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 361,
              "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": 198.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 306.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 198.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 235.01
            },
            {
              "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": 96.91,
              "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": 296.02
            },
            {
              "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": 100.75,
              "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": 299.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 263.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 361,
              "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": 361,
              "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": 95.95,
              "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": 97.91,
              "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": 263.53
            },
            {
              "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": 96.91,
              "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": 98.55
            },
            {
              "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": 263.53
            },
            {
              "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": 235.01
            },
            {
              "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": 316.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 263.53
            },
            {
              "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": 96.91,
              "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": 306.85
            },
            {
              "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": 231.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 231.76
            },
            {
              "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": 235.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 228.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 306.85
            },
            {
              "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": 234.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 306.85
            },
            {
              "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": 306.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 296.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 306.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 200.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 231.76
            },
            {
              "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": 296.02
            },
            {
              "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": 361,
              "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": 95.95,
              "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": 198.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 228.15
            },
            {
              "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": 228.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 200.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 296.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 306.85
            },
            {
              "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": 96.91,
              "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": 306.85
            },
            {
              "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": 316.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 299.27
            },
            {
              "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": 361,
              "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": 317.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 231.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 231.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 231.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 306.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 228.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 198.55
            },
            {
              "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": 96.91,
              "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": 200.36
            },
            {
              "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": 299.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 270.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 361,
              "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": 361,
              "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": 97.91,
              "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": 231.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 231.76
            },
            {
              "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": 231.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 361,
              "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": 306.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 263.53
            },
            {
              "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": 97.91,
              "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": 306.85
            },
            {
              "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": 200.36
            },
            {
              "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": 292.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 292.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 361
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 270.75
            },
            {
              "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": 100.75,
              "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": 228.15
            },
            {
              "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": 231.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 296.02
            },
            {
              "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": 100.75,
              "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": 270.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 263.53
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Spine 1 Vw Specify Level",
      "code_information": [
        {
          "code": "PX-32000034",
          "type": "CDM"
        },
        {
          "code": "72020",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 313,
          "discounted_cash": 203.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.95
            },
            {
              "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": 200.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 228.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 313,
              "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": 313,
              "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": 266.05
            },
            {
              "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": 197.82
            },
            {
              "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": 80.93,
              "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": 200.95
            },
            {
              "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": 203.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 173.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 228.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.82
            },
            {
              "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": 80.93,
              "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": 203.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 203.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 256.66
            },
            {
              "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": 197.82
            },
            {
              "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": 313,
              "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": 173.72
            },
            {
              "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": 200.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 228.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 266.05
            },
            {
              "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": 228.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 313
            },
            {
              "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": 313,
              "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": 83.28,
              "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": 256.66
            },
            {
              "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": 80.1,
              "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": 83.28,
              "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": 80.93,
              "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": 253.22
            },
            {
              "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": 172.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 234.75
            },
            {
              "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": 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": 172.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "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": 256.66
            },
            {
              "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": 173.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 313,
              "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": 275.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 80.1,
              "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": 313,
              "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": 172.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.15
            },
            {
              "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": 79.31,
              "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": 313,
              "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": 203.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 259.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "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": 313,
              "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": 253.22
            },
            {
              "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": 79.31,
              "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": 63.2,
              "estimated_amount": 197.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 200.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 256.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 200.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 172.15
            },
            {
              "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": 173.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 259.48
            },
            {
              "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": 203.76
            },
            {
              "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": 313,
              "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": 313,
              "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": 83.28,
              "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": 256.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 80.1,
              "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": 80.1,
              "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": 313,
              "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": 266.05
            },
            {
              "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": 274.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 313,
              "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": 234.75
            },
            {
              "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": 200.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 256.66
            },
            {
              "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": 256.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 228.49
            },
            {
              "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": 259.48
            },
            {
              "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": 200.95
            },
            {
              "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": 80.1,
              "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": 203.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 228.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 234.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 266.05
            },
            {
              "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": 79.31,
              "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": 172.15
            },
            {
              "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": 266.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 197.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 313,
              "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": 274.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 200.95
            },
            {
              "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": 256.66
            },
            {
              "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": 85.45
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Sacrum/Coccyx 2 + Vw",
      "code_information": [
        {
          "code": "PX-32000052",
          "type": "CDM"
        },
        {
          "code": "72220",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 342,
          "discounted_cash": 222.3,
          "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": 219.56
            },
            {
              "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": 79.31,
              "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": 290.7
            },
            {
              "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": 299.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 216.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 222.3
            },
            {
              "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": 222.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 342,
              "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": 222.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 280.44
            },
            {
              "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": 80.1,
              "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": 342,
              "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": 188.1
            },
            {
              "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": 80.1,
              "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": 219.56
            },
            {
              "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": 189.81
            },
            {
              "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": 83.28,
              "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": 216.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 280.44
            },
            {
              "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": 80.93,
              "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": 342,
              "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": 256.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 283.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 188.1
            },
            {
              "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": 219.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 290.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 342
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 216.14
            },
            {
              "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": 219.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 280.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 283.52
            },
            {
              "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": 83.28,
              "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": 216.14
            },
            {
              "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": 216.14
            },
            {
              "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": 300.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 290.7
            },
            {
              "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": 280.44
            },
            {
              "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": 280.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 256.5
            },
            {
              "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": 79.31,
              "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": 342,
              "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": 290.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 188.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 342,
              "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": 249.66
            },
            {
              "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": 80.1,
              "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": 280.44
            },
            {
              "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": 290.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 216.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 216.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 219.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 290.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 80.93,
              "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": 276.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 256.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 290.7
            },
            {
              "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": 219.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 280.44
            },
            {
              "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": 83.28,
              "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": 80.1,
              "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": 219.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 290.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 283.52
            },
            {
              "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": 188.1
            },
            {
              "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": 249.66
            },
            {
              "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": 80.1,
              "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": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 290.7
            },
            {
              "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": 189.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 249.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 290.7
            },
            {
              "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": 276.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 222.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 222.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 342,
              "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": 216.14
            },
            {
              "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": 342,
              "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": 342,
              "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": 249.66
            },
            {
              "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": 342,
              "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": 342,
              "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": 290.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 222.64
            },
            {
              "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": 280.44
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": 188.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 188.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 249.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 80.93,
              "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": 188.1
            },
            {
              "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": 290.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 189.81
            },
            {
              "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": 219.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 189.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 249.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 290.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 342,
              "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": 342,
              "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": 93.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 290.7
            },
            {
              "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": 299.93
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Shoulder 1 Vw",
      "code_information": [
        {
          "code": "PX-32000063",
          "type": "CDM"
        },
        {
          "code": "73020",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 294,
          "discounted_cash": 191.1,
          "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": 188.75
            },
            {
              "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": 83.28,
              "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": 258.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 249.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 243.73
            },
            {
              "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": 79.31,
              "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": 241.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 220.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 243.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 161.7
            },
            {
              "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": 188.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 249.9
            },
            {
              "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": 188.75
            },
            {
              "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": 80.93,
              "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": 161.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.28,
              "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": 80.1,
              "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": 188.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 188.75
            },
            {
              "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": 257.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 294,
              "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": 294,
              "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": 163.17
            },
            {
              "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": 185.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 80.1,
              "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": 294,
              "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": 163.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 214.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 188.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 237.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 241.08
            },
            {
              "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": 249.9
            },
            {
              "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": 185.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 241.08
            },
            {
              "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": 83.28,
              "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": 294,
              "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": 249.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 241.08
            },
            {
              "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": 241.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 294
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 214.62
            },
            {
              "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": 243.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 220.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 214.62
            },
            {
              "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": 80.1,
              "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": 188.75
            },
            {
              "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": 80.1,
              "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": 163.17
            },
            {
              "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": 79.31,
              "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": 80.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 185.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 249.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 161.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 185.81
            },
            {
              "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": 294,
              "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": 161.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 191.39
            },
            {
              "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": 191.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 249.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 161.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 294,
              "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": 249.9
            },
            {
              "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": 191.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 249.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 185.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 185.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 294,
              "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": 79.31,
              "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": 257.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 188.75
            },
            {
              "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": 241.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 241.08
            },
            {
              "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": 79.31,
              "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": 249.9
            },
            {
              "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": 294,
              "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": 80.93,
              "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": 188.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 191.39
            },
            {
              "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": 237.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 214.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 249.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 220.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 80.93,
              "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": 185.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 161.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 249.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 188.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 188.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 294,
              "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": 188.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 161.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 214.62
            },
            {
              "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": 80.1,
              "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": 185.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 294,
              "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": 214.62
            },
            {
              "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": 249.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 191.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 249.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 294,
              "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": 191.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 249.9
            },
            {
              "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": 241.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 163.17
            },
            {
              "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": 294,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Humerus 2 + Vw",
      "code_information": [
        {
          "code": "PX-32000067",
          "type": "CDM"
        },
        {
          "code": "73060",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 333,
          "discounted_cash": 216.45,
          "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": 213.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.09
            },
            {
              "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": 292.04
            },
            {
              "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": 333,
              "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": 333,
              "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": 249.75
            },
            {
              "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": 184.82
            },
            {
              "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": 273.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.09
            },
            {
              "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": 80.1,
              "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": 333,
              "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": 80.93,
              "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": 249.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 333,
              "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": 333,
              "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": 216.78
            },
            {
              "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": 81.52,
              "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": 216.78
            },
            {
              "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": 292.04
            },
            {
              "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": 80.1,
              "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": 283.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.15
            },
            {
              "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": 80.1,
              "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": 83.28,
              "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": 276.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.06
            },
            {
              "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": 333,
              "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": 333,
              "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": 333,
              "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": 249.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 333,
              "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": 80.93,
              "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": 283.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.06
            },
            {
              "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": 213.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "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": 216.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "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": 183.15
            },
            {
              "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": 273.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.06
            },
            {
              "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": 77.63,
              "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": 283.05
            },
            {
              "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,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.28,
              "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": 210.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 333,
              "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": 333,
              "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": 243.09
            },
            {
              "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": 79.31,
              "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": 90.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "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": 77.63,
              "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": 273.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 333,
              "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": 183.15
            },
            {
              "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": 243.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.46
            },
            {
              "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": 210.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 333,
              "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": 293.04
            },
            {
              "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": 184.82
            },
            {
              "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": 269.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.06
            },
            {
              "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": 210.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 269.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 333,
              "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": 184.82
            },
            {
              "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": 80.93,
              "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": 283.05
            },
            {
              "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": 80.1,
              "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": 184.82
            },
            {
              "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": 283.05
            },
            {
              "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": 213.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 333
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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,
              "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": 333,
              "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": 333,
              "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": 333,
              "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": 216.78
            },
            {
              "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": 80.1,
              "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": 333,
              "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": 213.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "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": 213.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.09
            },
            {
              "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": 333,
              "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": 183.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.46
            },
            {
              "payer_name": "MOLINA 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,
              "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": 216.78
            },
            {
              "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": 79.31,
              "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": 216.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 333,
              "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": 183.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.79
            },
            {
              "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": 273.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.06
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Forearm 2 Vw",
      "code_information": [
        {
          "code": "PX-32000071",
          "type": "CDM"
        },
        {
          "code": "73090",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 330,
          "discounted_cash": 214.5,
          "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": 211.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 330,
              "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": 330,
              "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": 330,
              "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": 214.83
            },
            {
              "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": 90.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 280.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 181.5
            },
            {
              "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": 211.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.86
            },
            {
              "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": 181.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 266.97
            },
            {
              "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": 83.28,
              "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": 211.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 83.15,
              "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": 330,
              "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": 214.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 280.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 280.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 208.56
            },
            {
              "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": 80.1,
              "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": 330,
              "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": 330,
              "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": 183.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 330,
              "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": 80.1,
              "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": 280.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 208.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 280.5
            },
            {
              "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": 83.28,
              "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": 270.6
            },
            {
              "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": 270.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 181.5
            },
            {
              "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": 214.83
            },
            {
              "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": 273.57
            },
            {
              "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": 211.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 214.83
            },
            {
              "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": 80.1,
              "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": 208.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 270.6
            },
            {
              "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": 183.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 240.9
            },
            {
              "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": 80.1,
              "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": 280.5
            },
            {
              "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": 83.28,
              "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": 240.9
            },
            {
              "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": 211.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 330
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 208.56
            },
            {
              "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": 280.5
            },
            {
              "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": 330,
              "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": 208.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 280.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 270.6
            },
            {
              "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": 270.6
            },
            {
              "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": 79.22,
              "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": 330,
              "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": 183.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 280.5
            },
            {
              "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": 266.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.86
            },
            {
              "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": 208.56
            },
            {
              "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": 289.41
            },
            {
              "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": 211.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 280.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 280.5
            },
            {
              "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": 280.5
            },
            {
              "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": 208.56
            },
            {
              "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": 290.4
            },
            {
              "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": 270.6
            },
            {
              "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": 183.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 330,
              "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": 273.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 273.57
            },
            {
              "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": 330,
              "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": 79.31,
              "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": 79.31,
              "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": 280.5
            },
            {
              "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": 330,
              "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": 330,
              "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": 211.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 330,
              "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": 214.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 330,
              "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": 181.5
            },
            {
              "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": 83.15,
              "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": 79.22,
              "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": 181.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 211.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 270.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 181.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 208.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 280.5
            },
            {
              "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": 80.1,
              "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": 270.6
            },
            {
              "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": 214.5
            },
            {
              "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": 289.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 181.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 240.9
            },
            {
              "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": 79.22,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Upper Extremity Infant 2 + Vw",
      "code_information": [
        {
          "code": "PX-32000072",
          "type": "CDM"
        },
        {
          "code": "73092",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 377,
          "discounted_cash": 245.05,
          "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": 242.03
            },
            {
              "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": 242.03
            },
            {
              "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": 96.91,
              "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": 95.95,
              "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": 377,
              "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": 377,
              "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": 245.43
            },
            {
              "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": 95.95,
              "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": 275.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.26
            },
            {
              "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": 377,
              "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": 320.45
            },
            {
              "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": 95.95,
              "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": 245.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 209.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 100.75,
              "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": 377,
              "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": 331.76
            },
            {
              "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": 209.24
            },
            {
              "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": 320.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 304.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 207.35
            },
            {
              "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": 96.91,
              "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": 377,
              "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": 320.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.14
            },
            {
              "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": 377,
              "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": 312.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.03
            },
            {
              "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": 245.43
            },
            {
              "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": 209.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 377,
              "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": 330.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 275.21
            },
            {
              "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": 209.24
            },
            {
              "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": 309.14
            },
            {
              "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": 309.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 95.95,
              "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": 207.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "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": 242.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.14
            },
            {
              "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": 102.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 96.91,
              "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": 320.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 377,
              "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": 320.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 97.91,
              "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": 377,
              "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": 312.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.14
            },
            {
              "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": 207.35
            },
            {
              "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": 96.91,
              "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": 100.75,
              "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": 238.26
            },
            {
              "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": 330.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 320.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.03
            },
            {
              "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": 377,
              "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": 282.75
            },
            {
              "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": 309.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 238.26
            },
            {
              "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": 97.91,
              "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": 245.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 377
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 309.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 282.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 304.99
            },
            {
              "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": 238.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 312.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 309.14
            },
            {
              "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": 320.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.26
            },
            {
              "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": 100.75,
              "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": 320.45
            },
            {
              "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": 242.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 377,
              "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": 377,
              "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": 245.43
            },
            {
              "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": 242.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.21
            },
            {
              "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": 96.91,
              "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": 242.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 320.45
            },
            {
              "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": 377,
              "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": 377,
              "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": 97.91,
              "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": 242.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 245.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 282.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.35
            }
          ]
        }
      ]
    },
    {
      "description": "HC Xr Arthrogram Hip",
      "code_information": [
        {
          "code": "PX-32000082",
          "type": "CDM"
        },
        {
          "code": "73525",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 751,
          "discounted_cash": 488.15,
          "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": 482.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 488.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 488.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "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": 751,
              "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": 339.01,
              "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": 488.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "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": 205.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 474.63
            },
            {
              "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": 658.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 751,
              "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": 615.82
            },
            {
              "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": 335.65,
              "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": 335.65,
              "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": 622.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 488.9
            },
            {
              "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": 751,
              "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": 548.23
            },
            {
              "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": 339.01,
              "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": 413.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 563.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 342.5,
              "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": 638.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "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": 488.15
            },
            {
              "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": 413.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 413.05
            },
            {
              "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": 482.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 413.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 751,
              "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": 342.5,
              "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": 482.14
            },
            {
              "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": 607.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "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": 488.9
            },
            {
              "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": 352.43,
              "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": 751,
              "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": 474.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 548.23
            },
            {
              "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": 339.01,
              "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": 658.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 413.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 638.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "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": 751,
              "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": 413.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 638.35
            },
            {
              "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": 416.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 622.58
            },
            {
              "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": 638.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 751,
              "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": 638.35
            },
            {
              "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": 548.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 474.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 615.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 751
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 660.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 413.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 548.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "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": 342.5,
              "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": 751,
              "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": 482.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 615.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 638.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 548.23
            },
            {
              "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": 352.43,
              "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": 335.65,
              "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": 751,
              "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": 751,
              "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": 607.56
            },
            {
              "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": 339.01,
              "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": 751,
              "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": 563.25
            },
            {
              "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": 482.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 482.14
            },
            {
              "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": 339.01,
              "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": 638.35
            },
            {
              "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": 335.65,
              "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": 615.82
            },
            {
              "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": 622.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 638.35
            },
            {
              "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": 615.82
            },
            {
              "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": 352.43,
              "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": 638.35
            },
            {
              "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": 474.63
            },
            {
              "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": 416.81
            },
            {
              "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": 416.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 548.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 751,
              "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": 416.81
            },
            {
              "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": 482.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 563.25
            },
            {
              "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": 751,
              "additional_payer_notes": "ALL OTHER OP"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Corpora Cavernosogram",
      "code_information": [
        {
          "code": "PX-32000136",
          "type": "CDM"
        },
        {
          "code": "74445",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1945,
          "discounted_cash": 1264.25,
          "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": 1248.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1594.9
            },
            {
              "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": 1419.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1069.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1229.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1653.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1612.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1248.69
            },
            {
              "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": 1705.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1594.9
            },
            {
              "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": 1594.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1653.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1653.25
            },
            {
              "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": 1248.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1573.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1248.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1229.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1079.48
            },
            {
              "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": 1229.24
            },
            {
              "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": 1945,
              "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": 1594.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1266.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1711.6
            },
            {
              "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": 1079.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1458.75
            },
            {
              "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": 1069.75
            },
            {
              "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": 1266.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1069.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1069.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1419.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1458.75
            },
            {
              "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": 1229.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1945
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1248.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1069.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1266.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1653.25
            },
            {
              "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": 1945,
              "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": 1945,
              "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": 1248.69
            },
            {
              "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": 1653.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1594.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1419.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1419.85
            },
            {
              "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": 1945,
              "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": 1945,
              "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": 1248.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1069.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1069.75
            },
            {
              "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": 1248.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1653.25
            },
            {
              "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": 1573.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1594.9
            },
            {
              "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": 1248.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1945,
              "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": 1945,
              "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": 1945,
              "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": 1248.69
            },
            {
              "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": 1079.48
            },
            {
              "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": 530.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1419.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1266.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1266.2
            },
            {
              "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": 1594.9
            },
            {
              "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": 1248.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1653.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1229.24
            },
            {
              "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": 1612.41
            },
            {
              "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": 1945,
              "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": 1945,
              "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": 1653.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1458.75
            },
            {
              "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": 1705.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1229.24
            },
            {
              "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": 1264.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1612.41
            },
            {
              "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": 1653.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1229.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1248.69
            },
            {
              "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": 1079.48
            },
            {
              "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": 1229.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1594.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1945,
              "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": 1653.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1653.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1419.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1945,
              "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": 1653.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC Urethrocystogram Voiding",
      "code_information": [
        {
          "code": "PX-32000138",
          "type": "CDM"
        },
        {
          "code": "74455",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 884,
          "discounted_cash": 574.6,
          "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": 567.53
            },
            {
              "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": 567.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 751.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 567.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 663
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 884,
              "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": 490.62
            },
            {
              "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": 490.62
            },
            {
              "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": 884,
              "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": 751.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 486.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 558.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 567.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 724.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 645.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 884,
              "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": 884,
              "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": 645.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 645.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 575.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 724.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 218.23,
              "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": 645.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 558.69
            },
            {
              "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": 775.27
            },
            {
              "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": 558.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 884,
              "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": 486.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 645.32
            },
            {
              "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": 567.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 751.4
            },
            {
              "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": 884,
              "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": 241.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 751.4
            },
            {
              "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": 884,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 216,
              "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": 884,
              "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": 567.53
            },
            {
              "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": 575.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 732.84
            },
            {
              "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": 751.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 715.16
            },
            {
              "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": 558.69
            },
            {
              "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": 884,
              "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": 777.92
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 224.56,
              "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": 213.87,
              "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": 558.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.2
            },
            {
              "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": 224.56,
              "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": 724.88
            },
            {
              "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": 775.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 558.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 751.4
            },
            {
              "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": 490.62
            },
            {
              "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": 213.87,
              "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": 575.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 724.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 884,
              "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": 724.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 724.88
            },
            {
              "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": 218.23,
              "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": 751.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 751.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 218.23,
              "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": 575.48
            },
            {
              "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": 486.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 645.32
            },
            {
              "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": 567.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 567.53
            },
            {
              "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": 724.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 751.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 751.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 751.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 567.53
            },
            {
              "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": 567.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 663
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 574.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 575.48
            },
            {
              "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": 213.87,
              "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": 751.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 486.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 884
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 558.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 884,
              "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": 751.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 567.53
            },
            {
              "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": 567.53
            },
            {
              "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": 715.16
            },
            {
              "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": 724.88
            },
            {
              "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": 213.87,
              "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": 884,
              "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": 216,
              "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": 751.4
            },
            {
              "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": 558.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 490.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 663
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 216,
              "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": 216,
              "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": 216,
              "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": 732.84
            },
            {
              "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": 732.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 884,
              "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": 224.56,
              "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": 486.2
            }
          ]
        }
      ]
    },
    {
      "description": "HC Shuntogram Nonvascular",
      "code_information": [
        {
          "code": "PX-32000149",
          "type": "CDM"
        },
        {
          "code": "75809",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 521,
          "discounted_cash": 338.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 427.22
            },
            {
              "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": 427.22
            },
            {
              "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": 95.95,
              "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": 286.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.33
            },
            {
              "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": 329.27
            },
            {
              "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": 100.75,
              "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": 334.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.48
            },
            {
              "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": 289.16
            },
            {
              "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": 95.95,
              "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": 521,
              "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": 521,
              "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": 521,
              "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": 521,
              "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": 431.91
            },
            {
              "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": 96.91,
              "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": 142.23
            },
            {
              "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": 427.22
            },
            {
              "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": 96.91,
              "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": 329.27
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 97.91,
              "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": 442.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.55
            },
            {
              "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": 521,
              "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": 442.85
            },
            {
              "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": 339.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 329.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 427.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 521,
              "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": 339.17
            },
            {
              "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": 427.22
            },
            {
              "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": 100.75,
              "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": 96.91,
              "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": 521,
              "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": 421.49
            },
            {
              "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": 339.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.55
            },
            {
              "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": 521,
              "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": 329.27
            },
            {
              "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": 95.95,
              "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": 338.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 339.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "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": 97.91,
              "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": 427.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 521,
              "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": 521,
              "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": 97.91,
              "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": 286.55
            },
            {
              "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": 289.16
            },
            {
              "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": 442.85
            },
            {
              "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": 289.16
            },
            {
              "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": 521,
              "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": 456.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 334.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 521,
              "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": 442.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 339.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 289.16
            },
            {
              "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": 456.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.27
            },
            {
              "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": 100.75,
              "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": 286.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 431.91
            },
            {
              "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": 96.91,
              "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": 521,
              "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": 421.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 96.91,
              "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": 63.2,
              "estimated_amount": 329.27
            },
            {
              "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": 334.48
            },
            {
              "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": 334.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.55
            },
            {
              "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": 458.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.33
            },
            {
              "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": 334.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 427.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 521
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 521,
              "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": 95.95,
              "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": 431.91
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 427.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 521,
              "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": 442.85
            },
            {
              "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": 521,
              "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": 380.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.48
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mammary Ductogram or Galactogram Sgl",
      "code_information": [
        {
          "code": "PX-32000206",
          "type": "CDM"
        },
        {
          "code": "77053",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 517,
          "discounted_cash": 336.05,
          "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": 331.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 517,
              "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": 453.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 517,
              "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": 517,
              "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": 423.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "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": 423.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "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": 284.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 517,
              "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": 439.45
            },
            {
              "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": 418.25
            },
            {
              "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": 326.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 387.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 286.94
            },
            {
              "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": 517,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "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": 326.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "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": 423.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 517,
              "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": 326.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "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": 517,
              "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": 439.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 428.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 331.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "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": 517,
              "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": 331.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "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": 336.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 439.45
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 336.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 336.05
            },
            {
              "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": 286.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 454.96
            },
            {
              "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": 377.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 428.59
            },
            {
              "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": 517,
              "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": 331.91
            },
            {
              "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": 326.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "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": 336.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 418.25
            },
            {
              "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": 453.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 439.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 439.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 286.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 439.45
            },
            {
              "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": 423.94
            },
            {
              "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": 286.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 387.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 336.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 423.94
            },
            {
              "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": 428.59
            },
            {
              "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": 439.45
            },
            {
              "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": 517,
              "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": 517
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 336.57
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 331.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 326.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 517,
              "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": 517,
              "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": 439.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 284.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 377.41
            },
            {
              "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": 331.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 387.75
            },
            {
              "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": 141.14
            }
          ]
        }
      ]
    },
    {
      "description": "HC Angio Iliac Artery W Cath",
      "code_information": [
        {
          "code": "PX-32300019",
          "type": "CDM"
        },
        {
          "code": "G0278",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3949,
          "discounted_cash": 2566.85,
          "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": 2535.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2171.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 2535.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2535.26
            },
            {
              "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": 3238.18
            },
            {
              "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": 3194.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 2495.77
            },
            {
              "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": 3463.27
            },
            {
              "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": 3238.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 2171.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2882.77
            },
            {
              "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": 2535.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2495.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 3356.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2171.95
            },
            {
              "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": 1078.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2535.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2535.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3194.74
            },
            {
              "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": 3949,
              "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": 3356.65
            },
            {
              "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": 3356.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3356.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2961.75
            },
            {
              "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": 2535.26
            },
            {
              "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": 2535.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3273.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2882.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2495.77
            },
            {
              "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": 3949,
              "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": 3949,
              "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": 3949,
              "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": 3949,
              "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": 3949,
              "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": 3273.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2171.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2171.95
            },
            {
              "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": 2171.95
            },
            {
              "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": 3949,
              "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": 3949,
              "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": 3356.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2495.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 3356.65
            },
            {
              "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": 2566.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2882.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3238.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3238.18
            },
            {
              "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": 3238.18
            },
            {
              "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": 2882.77
            },
            {
              "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": 3463.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 3949,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2495.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3356.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3356.65
            },
            {
              "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": 3273.72
            },
            {
              "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": 3356.65
            },
            {
              "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": 2570.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3356.65
            },
            {
              "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": 2495.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2171.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2535.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2535.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2535.26
            },
            {
              "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": 2495.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3356.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3356.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 3949,
              "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": 2495.77
            },
            {
              "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": 2535.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2961.75
            },
            {
              "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": 2570.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2570.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3238.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 2882.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 3475.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2570.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3238.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2961.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2882.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2570.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3238.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3949,
              "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": 3949,
              "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": 3949,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Chemo Sq Im Horm Antineoplast",
      "code_information": [
        {
          "code": "PX-33100002",
          "type": "CDM"
        },
        {
          "code": "96402",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 440,
          "discounted_cash": 286,
          "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": 282.48
            },
            {
              "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": 64.56,
              "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": 440,
              "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": 62.74,
              "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": 282.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 62.74,
              "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": 282.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 282.48
            },
            {
              "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": 355.96
            },
            {
              "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": 385.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 440,
              "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": 374
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 242
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 321.2
            },
            {
              "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": 282.48
            },
            {
              "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": 282.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 282.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 278.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 374
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 61.48,
              "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": 242
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.1,
              "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": 62.1,
              "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": 440,
              "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": 374
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 364.76
            },
            {
              "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": 286.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 440,
              "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": 440,
              "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": 440,
              "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": 374
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 286
            },
            {
              "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": 440,
              "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": 387.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 374
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 374
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 282.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 330
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 282.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 321.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 321.2
            },
            {
              "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": 64.56,
              "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": 282.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 440
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 244.2
            },
            {
              "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": 278.08
            },
            {
              "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": 385.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 278.08
            },
            {
              "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": 62.74,
              "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": 286.44
            },
            {
              "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": 440,
              "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": 321.2
            },
            {
              "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": 374
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 286.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 360.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 244.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 374
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 61.48,
              "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": 282.48
            },
            {
              "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": 286.44
            },
            {
              "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": 244.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 440,
              "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": 278.08
            },
            {
              "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": 62.1,
              "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": 374
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 374
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 244.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 242
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 278.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 360.8
            },
            {
              "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": 360.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 330
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.1,
              "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": 374
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 61.48,
              "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": 360.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 440,
              "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": 374
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 364.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 355.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 321.2
            },
            {
              "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": 440,
              "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": 242
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 321.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 278.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 374
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 360.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 374
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.1,
              "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": 278.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 360.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 242
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 282.48
            },
            {
              "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": 440,
              "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": 61.48,
              "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": 360.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 242
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 286.44
            },
            {
              "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": 64.56,
              "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": 364.76
            },
            {
              "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": 360.8
            },
            {
              "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": 278.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 440,
              "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": 440,
              "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": 242
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 120.12
            }
          ]
        }
      ]
    },
    {
      "description": "HC Dosimetry Special",
      "code_information": [
        {
          "code": "PX-33300015",
          "type": "CDM"
        },
        {
          "code": "77331",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1081,
          "discounted_cash": 702.65,
          "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": 694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 1081,
              "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": 599.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 918.85
            },
            {
              "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": 948.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 1081,
              "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": 118.42,
              "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": 703.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 918.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 119.61,
              "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": 694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 1081,
              "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": 918.85
            },
            {
              "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": 789.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 599.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 810.75
            },
            {
              "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": 694
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 124.35,
              "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": 120.84,
              "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": 599.96
            },
            {
              "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": 948.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 703.73
            },
            {
              "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": 703.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 896.15
            },
            {
              "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": 1081,
              "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": 1081,
              "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": 119.61,
              "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": 124.35,
              "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": 118.42,
              "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": 683.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 918.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 810.75
            },
            {
              "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": 295.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 918.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 918.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.13
            },
            {
              "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": 1081,
              "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": 918.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 886.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1081
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 119.61,
              "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": 874.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 886.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 1081,
              "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": 918.85
            },
            {
              "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": 1081,
              "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": 594.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 810.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 874.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 594.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 594.55
            },
            {
              "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": 119.61,
              "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": 896.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 703.73
            },
            {
              "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": 886.42
            },
            {
              "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": 918.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 594.55
            },
            {
              "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": 124.35,
              "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": 918.85
            },
            {
              "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": 694
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 703.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 896.15
            },
            {
              "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": 1081,
              "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": 683.19
            },
            {
              "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": 683.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 120.84,
              "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": 594.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 886.42
            },
            {
              "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": 118.42,
              "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": 594.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1081,
              "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": 236.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 886.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 918.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 886.42
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.84,
              "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": 918.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 694
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 789.13
            },
            {
              "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": 1081,
              "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": 886.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 594.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 119.61,
              "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": 918.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 118.42,
              "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": 886.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 702.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 683.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 1081,
              "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": 951.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 918.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1081,
              "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": 599.96
            }
          ]
        }
      ]
    },
    {
      "description": "HC Lymphoscintigram",
      "code_information": [
        {
          "code": "PX-34100013",
          "type": "CDM"
        },
        {
          "code": "78195",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2375,
          "discounted_cash": 1543.75,
          "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": 1524.75
            },
            {
              "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": 1524.75
            },
            {
              "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": 2090
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1947.5
            },
            {
              "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": 1501
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 520.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1318.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1968.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "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": 2082.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "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": 2375,
              "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": 2018.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1921.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 2375,
              "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": 1524.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 471.75,
              "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": 1733.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1733.75
            },
            {
              "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": 476.46,
              "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": 2375,
              "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": 1781.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "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": 471.75,
              "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": 2375,
              "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": 481.37,
              "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": 1543.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1947.5
            },
            {
              "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": 1524.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1524.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1524.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2375
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1501
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2375,
              "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": 2018.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1306.25
            },
            {
              "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": 471.75,
              "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": 1501
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1501
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 2018.75
            },
            {
              "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": 471.75,
              "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": 476.46,
              "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": 1318.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1781.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1947.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1546.13
            },
            {
              "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": 1947.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 1546.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1546.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 2375,
              "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": 481.37,
              "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": 1306.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1733.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1781.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1546.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1306.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1733.75
            },
            {
              "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": 1318.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1968.88
            },
            {
              "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": 2082.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 2018.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1524.75
            },
            {
              "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": 1921.38
            },
            {
              "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": 1947.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1524.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "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": 476.46,
              "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": 481.37,
              "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": 1501
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "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": 1524.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1306.25
            },
            {
              "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": 1318.13
            },
            {
              "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": 1733.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1733.75
            },
            {
              "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": 1524.75
            },
            {
              "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": 1501
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 1968.88
            },
            {
              "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": 2375,
              "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": 1947.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1947.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2018.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 2375,
              "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": 1524.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1306.25
            },
            {
              "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": 495.33,
              "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": 1306.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1306.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 2375,
              "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": 648.38
            },
            {
              "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": 495.33,
              "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": 476.46,
              "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": 476.46,
              "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": 2375,
              "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": 1546.13
            },
            {
              "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": 2018.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2375,
              "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": 2018.75
            },
            {
              "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": 2375,
              "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": 1501
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1947.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1501
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1524.75
            },
            {
              "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": 495.33,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC GI Bleed Scan",
      "code_information": [
        {
          "code": "PX-34100024",
          "type": "CDM"
        },
        {
          "code": "78278",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4258,
          "discounted_cash": 2767.7,
          "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": 2733.64
            },
            {
              "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": 363.57,
              "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": 4258,
              "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": 359.55,
              "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": 3619.3
            },
            {
              "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": 4258,
              "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": 3619.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3108.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2733.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3193.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2363.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 4258,
              "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": 3619.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2733.64
            },
            {
              "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": 352.36,
              "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": 2733.64
            },
            {
              "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": 3734.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 2767.7
            },
            {
              "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": 2771.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2771.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 2341.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3491.56
            },
            {
              "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": 3491.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2691.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 2341.9
            },
            {
              "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": 363.57,
              "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": 4258,
              "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": 2363.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3193.5
            },
            {
              "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": 3619.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 3491.56
            },
            {
              "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": 369.98,
              "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": 2733.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2341.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3108.34
            },
            {
              "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": 3444.72
            },
            {
              "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": 3734.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2341.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2691.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 363.57,
              "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": 3108.34
            },
            {
              "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": 2733.64
            },
            {
              "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": 4258,
              "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": 2733.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 359.55,
              "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": 363.57,
              "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": 377.97,
              "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": 4258,
              "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": 4258,
              "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": 2733.64
            },
            {
              "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": 2691.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 3108.34
            },
            {
              "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": 377.97,
              "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": 3108.34
            },
            {
              "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": 4258,
              "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": 3529.88
            },
            {
              "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": 3619.3
            },
            {
              "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": 3529.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2691.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "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": 3747.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "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": 352.36,
              "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": 3444.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2771.96
            },
            {
              "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": 3491.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2341.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2691.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 4258,
              "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": 2771.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3491.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2691.06
            },
            {
              "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": 932.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "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": 2691.06
            },
            {
              "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": 1162.43
            },
            {
              "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": 2771.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 2691.06
            },
            {
              "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": 2363.19
            },
            {
              "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": 2733.64
            },
            {
              "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": 363.57,
              "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": 2341.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4258,
              "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": 4258,
              "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": 352.36,
              "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": 2733.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3529.88
            },
            {
              "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": 4258,
              "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": 3491.56
            },
            {
              "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": 4258,
              "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": 2363.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2733.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3193.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3491.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 359.55,
              "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": 352.36,
              "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": 4258
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2341.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3108.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2733.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3491.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3619.3
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe Only 30cc Slip Tip",
      "code_information": [
        {
          "code": "PX-CH-BD30-1626",
          "type": "CDM"
        },
        {
          "code": "A4213",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.03,
          "discounted_cash": 0.67,
          "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": 0.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.28
            },
            {
              "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": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 1.03,
              "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": 1.03,
              "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": 0.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.77
            },
            {
              "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": 1.03,
              "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": 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": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 0.65
            },
            {
              "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": 0.65
            },
            {
              "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": 0.9
            },
            {
              "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": 0.65
            },
            {
              "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": 0.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.03,
              "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": 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": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 0.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 0.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "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": 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": 0.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 0.57
            },
            {
              "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": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.03
            },
            {
              "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": 1.03,
              "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": 0.57
            },
            {
              "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": 1.03,
              "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": 0.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 0.67
            },
            {
              "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": 0.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.65
            },
            {
              "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": 1.03,
              "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": 0.57
            },
            {
              "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": 1.03,
              "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": 0.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.67
            },
            {
              "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": 0.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 1.03,
              "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": 0.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 0.66
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "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": 0.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.57
            },
            {
              "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": 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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "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": 0.75
            },
            {
              "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": 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": 1.03,
              "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": 0.66
            },
            {
              "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": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 1.03,
              "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": 0.57
            },
            {
              "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 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": 0.75
            },
            {
              "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": 0.84
            },
            {
              "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": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.03,
              "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": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.84
            }
          ]
        }
      ]
    },
    {
      "description": "HC Quant Pulm Perfusion W or WO Imaging",
      "code_information": [
        {
          "code": "PX-34100049",
          "type": "CDM"
        },
        {
          "code": "78597",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1002,
          "discounted_cash": 651.3,
          "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": 643.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 851.7
            },
            {
              "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": 1002,
              "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": 633.26
            },
            {
              "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": 633.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 731.46
            },
            {
              "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": 1002,
              "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": 731.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 643.28
            },
            {
              "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": 363.57,
              "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": 851.7
            },
            {
              "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": 1002,
              "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": 1002
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 643.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 556.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1002,
              "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": 643.28
            },
            {
              "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": 821.64
            },
            {
              "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": 821.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 1002,
              "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": 878.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 643.28
            },
            {
              "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": 643.28
            },
            {
              "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": 643.28
            },
            {
              "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": 821.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 551.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 643.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 810.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 821.64
            },
            {
              "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": 273.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 551.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 633.26
            },
            {
              "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": 878.75
            },
            {
              "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": 652.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 633.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 731.46
            },
            {
              "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": 367.32,
              "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": 63.2,
              "estimated_amount": 633.26
            },
            {
              "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": 219.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 551.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1002,
              "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": 851.7
            },
            {
              "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": 881.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 1002,
              "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": 643.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 751.5
            },
            {
              "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": 643.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 652.3
            },
            {
              "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": 652.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 556.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 1002,
              "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": 1002,
              "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": 551.1
            },
            {
              "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": 377.97,
              "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": 1002,
              "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": 851.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 643.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 551.1
            },
            {
              "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": 810.62
            },
            {
              "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": 359.97,
              "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": 551.1
            },
            {
              "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": 359.97,
              "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": 851.7
            },
            {
              "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": 363.57,
              "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": 830.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 363.57,
              "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": 851.7
            },
            {
              "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": 363.57,
              "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": 556.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 821.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 851.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 751.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 731.46
            },
            {
              "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": 651.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 643.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 652.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 851.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 851.7
            },
            {
              "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": 851.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 1002,
              "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": 367.32,
              "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": 851.7
            },
            {
              "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": 556.11
            },
            {
              "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": 359.97,
              "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": 377.97,
              "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": 731.46
            },
            {
              "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": 377.97,
              "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": 830.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 751.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 633.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1002,
              "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": 652.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 830.66
            },
            {
              "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": 551.1
            },
            {
              "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": 633.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 731.46
            },
            {
              "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": 851.7
            },
            {
              "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": 1002,
              "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": 367.32,
              "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": 359.97,
              "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": 821.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 821.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 821.64
            },
            {
              "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": 363.57,
              "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": 851.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 851.7
            },
            {
              "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": 633.26
            }
          ]
        }
      ]
    },
    {
      "description": "HC CSF Leak Detection",
      "code_information": [
        {
          "code": "PX-34100059",
          "type": "CDM"
        },
        {
          "code": "78650",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2986,
          "discounted_cash": 1940.9,
          "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": 1917.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2448.52
            },
            {
              "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": 2618.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2239.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1657.23
            },
            {
              "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": 1943.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2239.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 1657.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1642.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1917.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2448.52
            },
            {
              "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": 1887.15
            },
            {
              "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": 1887.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2986,
              "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": 1917.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 2986,
              "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": 2986,
              "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": 2986,
              "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": 2448.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 2986,
              "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": 2475.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1887.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2179.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2179.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1943.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1917.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2475.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1917.01
            },
            {
              "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": 2448.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "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": 2448.52
            },
            {
              "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": 2986,
              "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": 2475.39
            },
            {
              "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": 2538.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1642.3
            },
            {
              "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": 2627.68
            },
            {
              "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": 1657.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1887.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1917.01
            },
            {
              "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": 2448.52
            },
            {
              "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": 815.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 2179.78
            },
            {
              "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": 1917.01
            },
            {
              "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": 1917.01
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1642.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1887.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1642.3
            },
            {
              "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": 1657.23
            },
            {
              "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": 2415.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 2986,
              "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": 2986,
              "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": 2986,
              "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": 2986,
              "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": 2179.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 2986,
              "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": 1917.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "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": 1917.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2415.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2448.52
            },
            {
              "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": 1887.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2986
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2986,
              "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": 1642.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 1940.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1943.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1943.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2179.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1917.01
            },
            {
              "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": 1917.01
            },
            {
              "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": 1943.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1642.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1887.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1642.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2179.78
            },
            {
              "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": 2538.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1887.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2448.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2986,
              "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": 2986,
              "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": 2986,
              "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": 2618.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2538.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2239.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC CT Soft Tissue Neck W Contrast",
      "code_information": [
        {
          "code": "PX-35100011",
          "type": "CDM"
        },
        {
          "code": "70491",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1581,
          "discounted_cash": 1027.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "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": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1343.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1581,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 346.24
            },
            {
              "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": 1386.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1581,
              "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": 1581,
              "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": 1279.03
            },
            {
              "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": 1310.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1310.65
            },
            {
              "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": 1029.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.13
            },
            {
              "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": 869.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1157.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 869.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1343.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1581,
              "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": 1154.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.13
            },
            {
              "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": 161.96,
              "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": 1581
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1185.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1581,
              "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": 1581,
              "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": 1581,
              "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": 1343.85
            },
            {
              "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": 1163.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1029.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1029.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1157.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1185.75
            },
            {
              "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": 1163.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1343.85
            },
            {
              "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": 1581,
              "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": 1581,
              "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": 163.63,
              "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": 1296.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1185.75
            },
            {
              "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": 1296.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1296.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1343.85
            },
            {
              "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": 1157.29
            },
            {
              "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": 1296.42
            },
            {
              "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": 160.36,
              "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": 160.36,
              "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": 161.96,
              "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": 1343.85
            },
            {
              "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": 160.36,
              "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": 1310.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1581,
              "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": 1581,
              "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": 73.5,
              "estimated_amount": 1162.04
            },
            {
              "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": 1162.04
            },
            {
              "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": 161.96,
              "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": 1343.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "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": 1029.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 1162.04
            },
            {
              "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": 168.38,
              "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": 73.2,
              "estimated_amount": 1157.29
            },
            {
              "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": 1157.29
            },
            {
              "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": 163.63,
              "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": 1343.85
            },
            {
              "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": 1391.28
            },
            {
              "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": 1163.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1029.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1296.42
            },
            {
              "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": 160.36,
              "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": 1343.85
            },
            {
              "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": 1296.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 869.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 168.38,
              "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": 1343.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 869.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1343.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1157.29
            },
            {
              "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": 1581,
              "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": 1581,
              "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": 1581,
              "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": 161.96,
              "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": 1581,
              "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": 1343.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "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": 163.63,
              "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": 869.55
            },
            {
              "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": 168.38,
              "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": 73.2,
              "estimated_amount": 1157.29
            },
            {
              "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": 161.96,
              "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": 1162.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1343.85
            },
            {
              "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": 1386.54
            },
            {
              "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": 1581,
              "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": 1581,
              "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": 73.6,
              "estimated_amount": 1163.62
            },
            {
              "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": 1163.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1581,
              "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": 869.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1154.13
            },
            {
              "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": 1581,
              "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": 1581,
              "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": 1027.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 869.55
            },
            {
              "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": 431.61
            },
            {
              "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": 1343.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 1157.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1296.42
            },
            {
              "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": 1154.13
            },
            {
              "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": 1581,
              "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": 1279.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1581,
              "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": 1296.42
            }
          ]
        }
      ]
    },
    {
      "description": "Insert Left Vad Arterial Access Percutaneous W/ Img",
      "code_information": [
        {
          "code": "PX-36000053",
          "type": "CDM"
        },
        {
          "code": "33990",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1405,
          "discounted_cash": 913.25,
          "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": 902.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 346.18,
              "estimated_amount": 346.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 349.64,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "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": 1232.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 346.18,
              "estimated_amount": 346.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1053.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 1405
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 363.49,
              "additional_payer_notes": "PHYSICIAN 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": 1405,
              "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": 1194.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 930.11
            },
            {
              "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": 383.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 1405
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "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": 914.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 346.18,
              "estimated_amount": 346.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 363.49,
              "additional_payer_notes": "PHYSICIAN 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": 902.01
            },
            {
              "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": 902.01
            },
            {
              "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": 1152.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "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": 887.96
            },
            {
              "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": 1405,
              "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": 1053.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "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": 902.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "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": 772.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 346.18,
              "estimated_amount": 346.18
            },
            {
              "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": 902.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "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": 1236.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1164.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "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": 1405,
              "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": 1194.25
            },
            {
              "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": 1025.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 349.64,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 349.64,
              "additional_payer_notes": "PHYSICIAN 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": 887.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 346.18,
              "estimated_amount": 346.18
            },
            {
              "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": 913.25
            },
            {
              "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": 307.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 914.66
            },
            {
              "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": 1152.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "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": 1136.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 930.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 930.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "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": 1194.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "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": 1405,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 1405
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 772.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 930.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 349.64,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 1405
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1405,
              "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": 1194.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "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": 1152.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1164.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1136.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 346.18,
              "estimated_amount": 346.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 1405
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1164.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 887.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1025.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 346.18,
              "estimated_amount": 346.18
            },
            {
              "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": 914.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 914.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1053.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 349.64,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "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": 887.96
            },
            {
              "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": 1232.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 897.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1152.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_dollar": 346.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 363.49,
              "additional_payer_notes": "PHYSICIAN FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1194.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 902.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 914.66
            }
          ],
          "minimum": 346.18,
          "maximum": 346.18
        }
      ]
    },
    {
      "description": "Remove Left Vad Percutaneous",
      "code_information": [
        {
          "code": "PX-36000055",
          "type": "CDM"
        },
        {
          "code": "33992",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 957,
          "discounted_cash": 622.05,
          "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": 614.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 614.39
            },
            {
              "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": 622.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 698.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 614.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 784.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 717.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 793.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 774.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 957
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 698.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 526.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 957,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 623.01
            },
            {
              "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": 784.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "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": 604.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 774.21
            },
            {
              "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": 623.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 957,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 698.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 604.82
            },
            {
              "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": 604.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 717.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 526.35
            },
            {
              "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": 793.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 957,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 614.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 698.61
            },
            {
              "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": 839.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "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": 614.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 957
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 604.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "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": 604.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 614.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 614.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 623.01
            },
            {
              "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": 784.74
            },
            {
              "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": 784.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 784.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 623.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 957,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 604.82
            },
            {
              "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": 813.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 698.61
            },
            {
              "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": 842.16
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 957,
              "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": 717.75
            },
            {
              "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": 526.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 526.35
            },
            {
              "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": 957,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 614.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 623.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 793.35
            },
            {
              "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": 614.39
            },
            {
              "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": 957,
              "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": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 784.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 698.61
            },
            {
              "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": 614.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 526.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 957
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 261.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 526.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 604.82
            },
            {
              "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": 839.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 957,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 604.82
            },
            {
              "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": 957,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "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": 614.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 957
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 957,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 957
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 784.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 526.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 614.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 813.45
            },
            {
              "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": 813.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 784.74
            }
          ]
        }
      ]
    },
    {
      "description": "\"Hydrogel Drsg Kerralite Cool 4-3/10\"\" X 4-3/10\"\" Adh Border\"",
      "code_information": [
        {
          "code": "PX-CH-87CWL1008",
          "type": "CDM"
        },
        {
          "code": "A6237",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.36,
          "discounted_cash": 3.48,
          "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": 3.44
            },
            {
              "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": 3.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 2.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.34
            },
            {
              "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": 4.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 5.36,
              "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": 3.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 4.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 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": 4.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 3.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.4
            },
            {
              "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": 5.36,
              "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": 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": 4.4
            },
            {
              "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": 2.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.97
            },
            {
              "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": 4.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            },
            {
              "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": 4.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 2.95
            },
            {
              "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": 4.56
            },
            {
              "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": 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": 4.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 5.36,
              "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": 5.36,
              "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": 3.44
            },
            {
              "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": 2.95
            },
            {
              "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": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 5.36,
              "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": 5.36,
              "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": 3.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.95
            },
            {
              "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": 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": 3.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.44
            },
            {
              "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": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 4.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 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": 3.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.39
            },
            {
              "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": 5.36,
              "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": 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": 3.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.36,
              "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": 4.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 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": 3.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            },
            {
              "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": 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": 1.46
            },
            {
              "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": 3.44
            },
            {
              "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": 3.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 5.36,
              "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": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.95
            },
            {
              "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": 5.36,
              "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": 5.36,
              "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": 5.36,
              "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": 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": 3.91
            },
            {
              "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": 4.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.36,
              "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": 3.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.56
            }
          ]
        }
      ]
    },
    {
      "description": "HC Vad Remove Extracorp Biventricular",
      "code_information": [
        {
          "code": "PX-36000008",
          "type": "CDM"
        },
        {
          "code": "33978",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4765,
          "discounted_cash": 3097.25,
          "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": 3059.13
            },
            {
              "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": 3059.13
            },
            {
              "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": 2620.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3011.48
            },
            {
              "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": 3011.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4765,
              "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": 3573.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "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": 3059.13
            },
            {
              "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": 3011.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 4765
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3102.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3011.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 4765
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2620.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2620.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4765,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3907.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3478.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3950.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3011.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3011.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "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": 3854.89
            },
            {
              "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": 3102.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3102.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 4765
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3573.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3478.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4765,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3011.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "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": 4765,
              "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": 2620.75
            },
            {
              "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": 4765,
              "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": 4193.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3478.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4765,
              "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": 3102.02
            },
            {
              "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": 3102.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2620.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3950.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4765,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3950.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3907.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4765,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2620.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3478.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 4765
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3907.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3907.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3573.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3011.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2620.75
            },
            {
              "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": 3907.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "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": 3097.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3478.45
            },
            {
              "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": 4765,
              "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": 4178.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4050.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "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": 4765,
              "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": 4050.25
            },
            {
              "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": 3059.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3907.3
            },
            {
              "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": 3907.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3478.45
            },
            {
              "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": 4050.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3059.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3907.3
            },
            {
              "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": 4178.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4765
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3854.89
            },
            {
              "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": 1300.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC Anesthesia Ea Addl 15 Minutes",
      "code_information": [
        {
          "code": "PX-36000011",
          "type": "CDM"
        },
        {
          "code": "36000011",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 640,
          "discounted_cash": 416,
          "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": 410.88
            },
            {
              "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": 174.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 640
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 640,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY 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,
              "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": 544
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 640
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 517.76
            },
            {
              "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": 410.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 524.8
            },
            {
              "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": 544
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 640,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480
            },
            {
              "payer_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
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.2
            },
            {
              "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": 524.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 640,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "MOLINA 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,
              "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": 524.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 640,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 404.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 640
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 530.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 416.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.2
            },
            {
              "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": 640,
              "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": 410.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 524.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 640
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 404.48
            },
            {
              "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": 404.48
            },
            {
              "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": 410.88
            },
            {
              "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": 404.48
            },
            {
              "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": 352
            },
            {
              "payer_name": "HUMANA [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
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 563.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 416.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 416.64
            },
            {
              "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": 524.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 524.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.88
            },
            {
              "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": 517.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 544
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 530.56
            },
            {
              "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": 416.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 404.48
            },
            {
              "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": 561.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.2
            },
            {
              "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": 404.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 404.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 640,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 524.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 404.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.88
            },
            {
              "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": 416.64
            },
            {
              "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": 410.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "UHC 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,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 530.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 524.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 640
            },
            {
              "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,
              "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": 561.28
            }
          ]
        }
      ]
    },
    {
      "description": "HC Hemoconcentration",
      "code_information": [
        {
          "code": "PX-36000018",
          "type": "CDM"
        },
        {
          "code": "36000018",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 889,
          "discounted_cash": 577.85,
          "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": 570.74
            },
            {
              "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": 561.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 889
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 648.97
            },
            {
              "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": 889,
              "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": 578.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "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": 755.65
            },
            {
              "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": 570.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 578.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 728.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 728.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 561.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 488.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 488.95
            },
            {
              "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": 736.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 561.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 570.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 561.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 728.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 889,
              "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": 889,
              "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": 561.85
            },
            {
              "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": 561.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 889,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 736.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 889
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 666.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 889,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 666.75
            },
            {
              "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": 570.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 488.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 561.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 561.85
            },
            {
              "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": 889,
              "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": 782.32
            },
            {
              "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": 755.65
            },
            {
              "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": 242.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 889,
              "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": 755.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 648.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 889
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 728.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 736.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 570.74
            },
            {
              "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": 728.98
            },
            {
              "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": 488.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 889,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 648.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 570.74
            },
            {
              "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": 570.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 570.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 728.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "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": 889,
              "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": 570.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 570.74
            },
            {
              "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": 578.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 488.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 578.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 719.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 728.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 577.85
            },
            {
              "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": 570.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "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": 779.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 648.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 570.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 755.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 889
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 488.95
            },
            {
              "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": 648.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 648.97
            },
            {
              "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": 719.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 666.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 578.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 889,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 779.65
            },
            {
              "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": 728.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 488.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 889
            }
          ]
        }
      ]
    },
    {
      "description": "HC or Cosmetic Addl 15 Minutes",
      "code_information": [
        {
          "code": "PX-36000024",
          "type": "CDM"
        },
        {
          "code": "36000024",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 80,
          "discounted_cash": 52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "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": 65.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.6
            },
            {
              "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": 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": 58.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 58.4
            },
            {
              "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": 51.36
            },
            {
              "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": 51.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 80
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 80,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 51.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 80,
              "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": 52.08
            },
            {
              "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": 70.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 60
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 80,
              "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": 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": 50.56
            },
            {
              "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": 50.56
            },
            {
              "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": 52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 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": 51.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 60
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 80
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 80,
              "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": 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": 70.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.4
            },
            {
              "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": 65.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 80,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.56
            },
            {
              "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": 50.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "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": 52.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 70.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 80
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 80,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 66.32
            },
            {
              "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": 21.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 60
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 80,
              "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": 66.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "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": 64.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66.2,
              "estimated_amount": 80
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 80,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 80,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.36
            },
            {
              "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": 68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 80,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 65.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 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": 66.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 64.72
            }
          ]
        }
      ]
    },
    {
      "description": "HC Repair Nail Bed",
      "code_information": [
        {
          "code": "PX-36100033",
          "type": "CDM"
        },
        {
          "code": "11760",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 935,
          "discounted_cash": 607.75,
          "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": 600.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 608.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 794.75
            },
            {
              "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": 600.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 608.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 775.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 822.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 935,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 514.25
            },
            {
              "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": 935,
              "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": 766.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 766.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 590.92
            },
            {
              "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": 600.27
            },
            {
              "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": 607.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 590.92
            },
            {
              "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": 820
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 590.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 600.27
            },
            {
              "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": 590.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 590.92
            },
            {
              "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": 756.42
            },
            {
              "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": 766.7
            },
            {
              "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": 794.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 600.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 766.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 514.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 682.55
            },
            {
              "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": 600.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 935,
              "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": 935,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 514.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 514.25
            },
            {
              "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": 820
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "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": 935,
              "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": 600.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 766.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 775.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 600.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 766.7
            },
            {
              "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": 255.26
            },
            {
              "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": 590.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 600.27
            },
            {
              "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": 608.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 682.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 756.42
            },
            {
              "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": 935,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 935,
              "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": 682.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 682.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 935,
              "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": 514.25
            },
            {
              "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": 775.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 590.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 935,
              "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": 682.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 600.27
            },
            {
              "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": 590.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 794.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 608.69
            },
            {
              "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": 766.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 600.27
            },
            {
              "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": 608.69
            },
            {
              "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": 794.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 514.25
            },
            {
              "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": 600.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 935,
              "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": 935,
              "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": 514.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 794.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 766.7
            }
          ]
        }
      ]
    },
    {
      "description": "HC Excision Nail Fold Toe",
      "code_information": [
        {
          "code": "PX-36100034",
          "type": "CDM"
        },
        {
          "code": "11765",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1205,
          "discounted_cash": 783.25,
          "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": 773.61
            },
            {
              "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": 1060.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1205,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 998.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 773.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 879.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 879.65
            },
            {
              "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": 773.61
            },
            {
              "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": 761.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 903.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1205,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 773.61
            },
            {
              "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": 773.61
            },
            {
              "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": 974.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 988.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 903.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 761.56
            },
            {
              "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": 784.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 784.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 782.05
            },
            {
              "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": 988.1
            },
            {
              "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": 328.97
            },
            {
              "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": 998.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1205,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 782.05
            },
            {
              "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": 783.25
            },
            {
              "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": 773.61
            },
            {
              "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": 761.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 761.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 662.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 773.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 988.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1205,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1205,
              "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": 662.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 879.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 879.65
            },
            {
              "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": 1205,
              "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": 1024.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 773.61
            },
            {
              "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": 773.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 761.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1205,
              "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": 879.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 662.75
            },
            {
              "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": 1205,
              "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": 1056.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "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": 1205,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 662.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 988.1
            },
            {
              "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": 1056.79
            },
            {
              "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": 756.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 761.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 761.56
            },
            {
              "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": 761.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 773.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 974.85
            },
            {
              "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": 1024.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 903.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "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": 988.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 782.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 988.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 662.75
            },
            {
              "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": 1024.25
            },
            {
              "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": 756.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1024.25
            },
            {
              "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": 662.75
            },
            {
              "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": 773.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1205,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 998.95
            },
            {
              "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": 784.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 662.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 784.46
            },
            {
              "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": 988.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 988.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 773.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 784.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 756.74
            },
            {
              "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": 756.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 782.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 879.65
            }
          ]
        }
      ]
    },
    {
      "description": "HC Bronchoscopy W Insert Bronchial Stent",
      "code_information": [
        {
          "code": "PX-36100143",
          "type": "CDM"
        },
        {
          "code": "31636",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5384,
          "discounted_cash": 3499.6,
          "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": 3456.53
            },
            {
              "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": 3456.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3402.69
            },
            {
              "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": 4721.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 5384,
              "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": 4576.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2961.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4414.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4576.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 3456.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4355.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3930.32
            },
            {
              "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": 3456.53
            },
            {
              "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": 3402.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4038
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2961.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3402.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4414.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3504.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4414.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4737.92
            },
            {
              "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": 4576.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4414.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4576.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4414.88
            },
            {
              "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": 3504.98
            },
            {
              "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": 4414.88
            },
            {
              "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": 3402.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2961.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 4576.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3930.32
            },
            {
              "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": 5384,
              "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": 5384,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3504.98
            },
            {
              "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": 4414.88
            },
            {
              "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": 3402.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 2961.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 3456.53
            },
            {
              "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": 4355.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4576.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2961.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 3499.6
            },
            {
              "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": 3930.32
            },
            {
              "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": 4576.4
            },
            {
              "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": 4414.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4038
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3930.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 5384,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4576.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3402.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3402.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 3930.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4576.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 3456.53
            },
            {
              "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": 1469.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4576.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5384,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4721.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4576.4
            },
            {
              "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": 4463.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3930.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4463.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4038
            },
            {
              "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": 5384,
              "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": 5384,
              "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": 4576.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2961.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3456.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3456.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3504.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3456.53
            },
            {
              "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": 3456.53
            },
            {
              "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": 5384,
              "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": 4463.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3456.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3456.53
            },
            {
              "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": 2961.2
            },
            {
              "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": 3504.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3402.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5384,
              "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": 5384,
              "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": 5384,
              "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": 5384,
              "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": 5384,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Perc Pleural Drnge W Ins Catheter WO Img",
      "code_information": [
        {
          "code": "PX-36100163",
          "type": "CDM"
        },
        {
          "code": "32556",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2266,
          "discounted_cash": 1472.9,
          "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": 1454.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1833.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1246.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1246.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1654.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 2266,
              "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": 1454.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1475.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1454.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1858.12
            },
            {
              "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": 2266,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1878.51
            },
            {
              "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": 1654.18
            },
            {
              "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": 1472.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1699.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1475.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1926.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1454.77
            },
            {
              "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": 1858.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1926.1
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2266,
              "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": 1878.51
            },
            {
              "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": 2266,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1454.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1699.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1432.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 2266,
              "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": 1926.1
            },
            {
              "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": 618.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1654.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2266,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1454.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1454.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1858.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1926.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1926.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1432.11
            },
            {
              "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": 1987.28
            },
            {
              "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": 2266,
              "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": 1454.77
            },
            {
              "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": 1926.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1858.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1246.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1432.11
            },
            {
              "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": 1475.17
            },
            {
              "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": 1432.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1654.18
            },
            {
              "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": 1246.3
            },
            {
              "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": 1432.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1454.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1926.1
            },
            {
              "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": 1454.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1432.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1833.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1475.17
            },
            {
              "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": 1432.11
            },
            {
              "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": 1858.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1699.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1858.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1858.12
            },
            {
              "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": 1987.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 2266,
              "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": 1246.3
            },
            {
              "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": 1475.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1926.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1926.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1926.1
            },
            {
              "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": 1454.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1994.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1654.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1246.3
            },
            {
              "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": 1926.1
            },
            {
              "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": 2266,
              "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": 1432.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 1858.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1926.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1246.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "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": 2266,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2266,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1654.18
            },
            {
              "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": 1454.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1878.51
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insertion Transvenous Electrode Dual",
      "code_information": [
        {
          "code": "PX-36100180",
          "type": "CDM"
        },
        {
          "code": "33217",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23085,
          "discounted_cash": 15005.25,
          "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": 14820.57
            },
            {
              "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": 14820.57
            },
            {
              "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": 14589.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 23085,
              "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": 14820.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12696.75
            },
            {
              "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": 19622.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16852.05
            },
            {
              "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": 19137.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16852.05
            },
            {
              "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": 7489.05,
              "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": 7785.65,
              "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": 23085,
              "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": 23085,
              "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": 4155.3
            },
            {
              "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": 18929.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 14589.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18929.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18929.7
            },
            {
              "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": 18929.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 7566.23,
              "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": 16852.05
            },
            {
              "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": 7489.05,
              "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": 14820.57
            },
            {
              "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": 7785.65,
              "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": 12696.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14589.72
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 23085
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17313.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14820.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14820.57
            },
            {
              "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": 15028.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18675.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12696.75
            },
            {
              "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": 16852.05
            },
            {
              "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": 7489.05,
              "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": 23085,
              "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": 14820.57
            },
            {
              "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": 14820.57
            },
            {
              "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": 18675.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17313.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14589.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14589.72
            },
            {
              "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": 7566.23,
              "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": 6302.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 23085,
              "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": 7566.23,
              "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": 19622.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "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": 7414.9,
              "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": 23085,
              "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": 14820.57
            },
            {
              "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": 18929.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 23085
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12696.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14820.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 19622.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17313.75
            },
            {
              "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": 20245.55
            },
            {
              "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": 5055.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18929.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19137.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "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": 7785.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 23085
            },
            {
              "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": 4155.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 23085,
              "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": 23085,
              "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": 23085,
              "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": 19622.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16852.05
            },
            {
              "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": 15005.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15028.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15028.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 23085
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20245.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 12696.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 23085
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "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": 14589.72
            },
            {
              "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": 14820.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "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": 7489.05,
              "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": 18929.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18929.7
            },
            {
              "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": 15028.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15028.34
            },
            {
              "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": 7414.9,
              "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": 19137.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12696.75
            },
            {
              "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": 23085,
              "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": 16852.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7489.05,
              "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": 14820.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 7414.9,
              "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": 12696.75
            },
            {
              "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": 14589.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 23085,
              "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": 7414.9,
              "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": 63.2,
              "estimated_amount": 14589.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19622.25
            },
            {
              "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": 20314.8
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection Thrombin Pseudoaneurysm",
      "code_information": [
        {
          "code": "PX-36100245",
          "type": "CDM"
        },
        {
          "code": "36002",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4608,
          "discounted_cash": 2995.2,
          "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": 2958.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2534.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2912.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 2958.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "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": 3727.87
            },
            {
              "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": 3778.56
            },
            {
              "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": 2534.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2534.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3456
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 3916.8
            },
            {
              "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": 553.77,
              "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": 2912.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2958.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3916.8
            },
            {
              "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": 2958.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3916.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3363.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2912.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 4055.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3456
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2958.34
            },
            {
              "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": 3778.56
            },
            {
              "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": 1257.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 2534.4
            },
            {
              "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": 3778.56
            },
            {
              "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": 553.77,
              "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": 3916.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3916.8
            },
            {
              "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": 4041.22
            },
            {
              "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": 559.48,
              "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": 548.29,
              "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": 4608,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2958.34
            },
            {
              "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": 2912.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 4608,
              "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": 559.48,
              "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": 2958.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 3363.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3820.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 553.77,
              "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": 3820.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3778.56
            },
            {
              "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": 2958.34
            },
            {
              "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": 2912.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 3916.8
            },
            {
              "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": 4608,
              "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": 3916.8
            },
            {
              "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": 4608,
              "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": 2958.34
            },
            {
              "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": 2999.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2999.81
            },
            {
              "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": 548.29,
              "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": 63.2,
              "estimated_amount": 2912.26
            },
            {
              "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": 2995.2
            },
            {
              "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": 3363.84
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 224
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2999.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3778.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3916.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3916.8
            },
            {
              "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": 575.7,
              "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": 2958.34
            },
            {
              "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": 3727.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 3916.8
            },
            {
              "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": 548.29,
              "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": 575.7,
              "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": 3820.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2999.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 2534.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3363.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4608,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4041.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 4608,
              "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": 2958.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2999.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3778.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2534.4
            },
            {
              "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": 553.77,
              "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": 575.7,
              "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": 548.29,
              "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": 3916.8
            },
            {
              "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": 4608,
              "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": 2912.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 3363.84
            },
            {
              "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": 4608,
              "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": 3916.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 3778.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3916.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2912.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3916.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3456
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2534.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3363.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3778.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4608,
              "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": 559.48,
              "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": 553.77,
              "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": 2958.34
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sel Cath Plc Vertebral Art Angio Vertebral Art",
      "code_information": [
        {
          "code": "PX-36100268",
          "type": "CDM"
        },
        {
          "code": "36226",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4494,
          "discounted_cash": 2921.1,
          "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": 2885.15
            },
            {
              "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": 3685.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2471.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2840.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "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": 3819.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2885.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 4494
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4494,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3635.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2925.59
            },
            {
              "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": 4494,
              "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": 4494,
              "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": 2471.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2471.7
            },
            {
              "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": 4844.22,
              "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": 4494,
              "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": 2925.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4494,
              "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": 4494,
              "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": 3280.62
            },
            {
              "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": 2885.15
            },
            {
              "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": 1226.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3370.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "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": 4844.22,
              "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": 3370.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2885.15
            },
            {
              "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": 4894.14,
              "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": 3685.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2885.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "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": 2471.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2885.15
            },
            {
              "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": 4844.22,
              "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": 3685.08
            },
            {
              "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": 4796.26,
              "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": 4494,
              "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": 3685.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3280.62
            },
            {
              "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": 2921.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3685.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2840.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2840.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "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": 3819.9
            },
            {
              "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": 4796.26,
              "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": 2885.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4494,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 4494
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3370.5
            },
            {
              "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": 5036.07,
              "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": 2840.21
            },
            {
              "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": 2885.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3685.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2840.21
            },
            {
              "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": 2840.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "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": 5036.07,
              "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": 4494,
              "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": 3941.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2840.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 2218
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2885.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2885.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3635.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 4494
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2471.7
            },
            {
              "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": 2885.15
            },
            {
              "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": 3941.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2925.59
            },
            {
              "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": 4796.26,
              "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": 3280.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3280.62
            },
            {
              "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": 2885.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3685.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "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": 3819.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "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": 2840.21
            },
            {
              "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": 4894.14,
              "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": 3954.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "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": 4844.22,
              "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": 4494,
              "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": 4494,
              "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": 4894.14,
              "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": 3819.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3685.08
            },
            {
              "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": 5036.07,
              "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": 3725.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "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": 4494,
              "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": 3280.62
            },
            {
              "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": 4844.22,
              "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": 2925.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 4494
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 4494
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3725.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4494,
              "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": 4494,
              "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": 3819.9
            },
            {
              "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": 2925.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2471.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3725.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2471.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            },
            {
              "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": 4796.26,
              "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": 3280.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3819.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC Sel Cath Plc Xtrnl Crtd Art Angio Xtrnl Crtd Circ",
      "code_information": [
        {
          "code": "PX-36100269",
          "type": "CDM"
        },
        {
          "code": "36227",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2041,
          "discounted_cash": 1326.65,
          "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": 1310.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1328.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1673.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 2041,
              "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": 1489.93
            },
            {
              "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": 1734.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1328.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "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": 1328.69
            },
            {
              "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": 2041,
              "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": 1789.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 1489.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1310.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1289.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 1530.75
            },
            {
              "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": 1326.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1489.93
            },
            {
              "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": 2041,
              "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": 1310.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 2041,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 1734.85
            },
            {
              "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": 557.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1530.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "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": 2041,
              "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": 2041,
              "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": 1289.91
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "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": 1122.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1489.93
            },
            {
              "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": 2041,
              "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": 2041,
              "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": 2041,
              "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": 1489.93
            },
            {
              "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": 2041,
              "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": 1289.91
            },
            {
              "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": 1796.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1691.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1651.17
            },
            {
              "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": 2041,
              "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": 2041,
              "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": 1673.62
            },
            {
              "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": 1310.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1328.69
            },
            {
              "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": 1673.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1122.55
            },
            {
              "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": 2041,
              "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": 1310.32
            },
            {
              "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": 1310.32
            },
            {
              "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": 1673.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 1310.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1691.99
            },
            {
              "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": 1310.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1310.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1310.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1122.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1489.93
            },
            {
              "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": 1289.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1289.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "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": 1673.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1122.55
            },
            {
              "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": 1328.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 2041,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 1789.96
            },
            {
              "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": 2041,
              "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": 2041,
              "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": 1734.85
            },
            {
              "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": 2041,
              "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": 2041,
              "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": 1651.17
            },
            {
              "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": 2041,
              "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": 1122.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 1734.85
            },
            {
              "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": 1310.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1289.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 2041,
              "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": 1734.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1122.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1673.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1673.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1122.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1289.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 2041,
              "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": 2041,
              "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": 1530.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1310.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1673.62
            },
            {
              "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": 2041,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1289.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2041,
              "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": 2041,
              "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": 2041,
              "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": 1691.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1734.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC Inj Sclerosant for Spider Veins Limb or Trunk",
      "code_information": [
        {
          "code": "PX-36100280",
          "type": "CDM"
        },
        {
          "code": "36468",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 586,
          "discounted_cash": 380.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 480.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 370.35
            },
            {
              "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": 370.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 381.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 480.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 586,
              "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": 322.3
            },
            {
              "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": 586,
              "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": 370.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 485.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.3
            },
            {
              "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": 427.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 498.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 480.52
            },
            {
              "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": 159.98
            },
            {
              "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": 480.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 480.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 427.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "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": 322.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 427.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 515.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 586,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 381.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 427.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 498.1
            },
            {
              "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": 376.21
            },
            {
              "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": 376.21
            },
            {
              "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": 376.21
            },
            {
              "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": 513.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 485.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 439.5
            },
            {
              "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": 586,
              "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": 586,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 474.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 586,
              "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": 370.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 485.79
            },
            {
              "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": 586,
              "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": 376.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 480.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 376.21
            },
            {
              "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": 381.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 586,
              "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": 586,
              "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": 498.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 427.78
            },
            {
              "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": 498.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "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": 513.92
            },
            {
              "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": 376.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 376.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 381.49
            },
            {
              "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": 381.49
            },
            {
              "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": 480.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "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": 322.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 586,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 439.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 427.78
            },
            {
              "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": 380.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.1
            },
            {
              "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": 474.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 480.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.21
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 439.5
            }
          ]
        }
      ]
    },
    {
      "description": "HC Therapeutic Apheresis for Wbc",
      "code_information": [
        {
          "code": "PX-36100290",
          "type": "CDM"
        },
        {
          "code": "36511",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4532,
          "discounted_cash": 2945.8,
          "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": 2909.54
            },
            {
              "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": 2950.33
            },
            {
              "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": 2950.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3852.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3852.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2864.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 4532,
              "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": 4532,
              "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": 2909.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3308.36
            },
            {
              "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": 4532,
              "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": 3852.2
            },
            {
              "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": 2909.54
            },
            {
              "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": 2909.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2864.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2864.22
            },
            {
              "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": 3974.56
            },
            {
              "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": 4532,
              "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": 2492.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3757.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3852.2
            },
            {
              "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": 4532,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2864.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 3852.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2909.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 3974.56
            },
            {
              "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": 3308.36
            },
            {
              "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": 4532,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 4532,
              "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": 4532,
              "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": 3716.24
            },
            {
              "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": 1237.24
            },
            {
              "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": 3757.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2909.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 3716.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3308.36
            },
            {
              "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": 3988.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3308.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3757.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2492.6
            },
            {
              "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": 3716.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3716.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3399
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2864.22
            },
            {
              "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": 2864.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 2950.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3716.24
            },
            {
              "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": 2492.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 4532,
              "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": 3716.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 3852.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4532,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3399
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2492.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3308.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 2945.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3716.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3399
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 2909.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2492.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3716.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3852.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "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": 2909.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2909.54
            },
            {
              "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": 3852.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2909.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3666.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2492.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2950.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2492.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2864.22
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3852.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3852.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3852.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3308.36
            },
            {
              "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": 2864.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2909.54
            },
            {
              "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": 3666.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2909.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4532,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2950.33
            },
            {
              "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": 3852.2
            }
          ]
        }
      ]
    },
    {
      "description": "HC Transcath Rtrvl Intrvas FB W Img",
      "code_information": [
        {
          "code": "PX-36100337",
          "type": "CDM"
        },
        {
          "code": "37197",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10772,
          "discounted_cash": 7001.8,
          "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": 6915.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8833.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 9156.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8929.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 10772,
              "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": 2723.19,
              "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": 9156.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 10772
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 10772,
              "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": 7012.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 10772,
              "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": 7012.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 10772
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7863.56
            },
            {
              "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": 2809.81,
              "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": 7012.57
            },
            {
              "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": 8833.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 9156.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1938.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 8833.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6915.62
            },
            {
              "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": 9447.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 10772,
              "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": 6915.62
            },
            {
              "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": 2723.19,
              "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": 9156.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6915.62
            },
            {
              "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": 2723.19,
              "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": 1938.96
            },
            {
              "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": 6915.62
            },
            {
              "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": 2809.81,
              "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": 9447.04
            },
            {
              "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": 2809.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 10772
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8929.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5924.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9156.2
            },
            {
              "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": 2778.76,
              "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": 5924.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 8833.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8079
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5924.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7863.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6807.9
            },
            {
              "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": 10772,
              "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": 8079
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9156.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 10772
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 6915.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6915.62
            },
            {
              "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": 2778.76,
              "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": 8714.55
            },
            {
              "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": 8833.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8833.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 6807.9
            },
            {
              "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": 6807.9
            },
            {
              "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": 2778.76,
              "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": 9156.2
            },
            {
              "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": 7012.57
            },
            {
              "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": 5924.6
            },
            {
              "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": 7863.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9156.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5924.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5924.6
            },
            {
              "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": 9479.36
            },
            {
              "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": 6915.62
            },
            {
              "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": 2859.35,
              "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": 9156.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9156.2
            },
            {
              "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": 8714.55
            },
            {
              "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": 10772,
              "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": 2723.19,
              "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": 5924.6
            },
            {
              "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": 2809.81,
              "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": 9156.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6807.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 7863.56
            },
            {
              "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": 2921.09,
              "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": 7012.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8833.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8833.04
            },
            {
              "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": 2940.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10772,
              "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": 10772,
              "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": 7863.56
            },
            {
              "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": 2921.09,
              "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": 10772,
              "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": 9156.2
            },
            {
              "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": 7001.8
            },
            {
              "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": 2809.81,
              "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": 6915.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8929.99
            },
            {
              "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": 9156.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9156.2
            },
            {
              "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": 2359.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8079
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6915.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6807.9
            },
            {
              "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": 6807.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6807.9
            },
            {
              "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": 6807.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 10772
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7863.56
            },
            {
              "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": 6915.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6915.62
            }
          ]
        }
      ]
    },
    {
      "description": "HC Tibiopero W Atherectmy Ea Addl",
      "code_information": [
        {
          "code": "PX-36100365",
          "type": "CDM"
        },
        {
          "code": "37233",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5068,
          "discounted_cash": 3294.2,
          "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": 3253.66
            },
            {
              "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": 2787.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 2787.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "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": 3202.98
            },
            {
              "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": 3253.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3299.27
            },
            {
              "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": 3294.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4201.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 2787.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "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": 3253.66
            },
            {
              "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": 1383.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 5068,
              "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": 3699.64
            },
            {
              "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": 5068,
              "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": 4100.01
            },
            {
              "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": 5068,
              "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": 5068,
              "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": 5068,
              "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": 5068,
              "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": 5068,
              "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": 3202.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "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": 5068,
              "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": 5068,
              "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": 5068,
              "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": 3253.66
            },
            {
              "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": 5068,
              "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": 5068,
              "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": 4307.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3299.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 5068,
              "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": 2787.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4201.37
            },
            {
              "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": 5068,
              "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": 4100.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2787.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "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": 1109.89
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5068,
              "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": 5068,
              "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": 5068,
              "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": 3801
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3299.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "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": 5068,
              "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": 4155.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 5068,
              "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": 3253.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3299.27
            },
            {
              "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": 4459.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3801
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "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": 3253.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "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": 5068,
              "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": 3202.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3299.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "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": 4444.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 3253.66
            },
            {
              "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": 4155.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "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": 4201.37
            },
            {
              "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": 3202.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "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": 5068,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3801
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3202.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5068,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4307.8
            },
            {
              "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": 3699.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4155.76
            },
            {
              "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": 4155.76
            },
            {
              "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": 4444.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "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": 4307.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3699.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3253.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5068,
              "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": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5068,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Unlisted Procedure Vascular Surg",
      "code_information": [
        {
          "code": "PX-36100372",
          "type": "CDM"
        },
        {
          "code": "37799",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 627,
          "discounted_cash": 407.55,
          "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": 402.53
            },
            {
              "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": 402.53
            },
            {
              "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": 627,
              "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": 627,
              "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": 532.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "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": 549.88
            },
            {
              "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": 575.7,
              "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": 532.95
            },
            {
              "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": 627,
              "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": 536.7,
              "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": 532.95
            },
            {
              "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": 396.26
            },
            {
              "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": 551.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 396.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 627,
              "additional_payer_notes": "ASC UNLISTED"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 553.77,
              "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": 402.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 507.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "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": 536.7,
              "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": 344.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "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": 407.55
            },
            {
              "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": 553.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 627
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 553.77,
              "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": 627,
              "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": 408.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 627,
              "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": 457.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "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": 532.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 408.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 396.26
            },
            {
              "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": 559.48,
              "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": 627,
              "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": 470.25
            },
            {
              "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": 559.48,
              "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": 532.95
            },
            {
              "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": 344.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 519.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 470.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 402.53
            },
            {
              "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": 507.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 627
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 536.7,
              "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": 514.14
            },
            {
              "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": 536.7,
              "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": 457.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 627,
              "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": 559.48,
              "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": 532.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "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": 514.14
            },
            {
              "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": 171.17
            },
            {
              "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": 553.77,
              "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": 627,
              "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": 402.53
            },
            {
              "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": 402.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "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": 563.54,
              "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": 627,
              "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": 408.18
            },
            {
              "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": 514.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "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": 396.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 519.78
            },
            {
              "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": 396.26
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 26.3,
              "estimated_amount": 164.9
            },
            {
              "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": 402.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 402.53
            },
            {
              "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": 408.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 627
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 402.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 514.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 470.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 396.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 575.7,
              "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": 627,
              "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": 344.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 457.71
            },
            {
              "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": 553.77,
              "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": 396.26
            },
            {
              "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": 549.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 627
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 519.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 627,
              "additional_payer_notes": "ASC UNLISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 396.26
            },
            {
              "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": 514.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 532.95
            },
            {
              "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": 627,
              "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": 344.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 408.18
            },
            {
              "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": 532.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 627,
              "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": 627,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 627
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 344.85
            }
          ]
        }
      ]
    },
    {
      "description": "HC Biopsy Salivary Gland Needle",
      "code_information": [
        {
          "code": "PX-36100381",
          "type": "CDM"
        },
        {
          "code": "42400",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2635,
          "discounted_cash": 1712.75,
          "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": 1691.67
            },
            {
              "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": 2160.7
            },
            {
              "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": 620.21,
              "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": 1665.32
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 626.6,
              "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": 2239.75
            },
            {
              "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": 1665.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 1712.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1715.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 2635
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 2635
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2160.7
            },
            {
              "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": 719.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1449.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1691.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1449.25
            },
            {
              "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": 2310.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 2131.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2239.75
            },
            {
              "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": 1691.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1691.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 1691.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2239.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1976.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1923.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 2635
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 614.07,
              "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": 2635,
              "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": 2635,
              "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": 1449.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1449.25
            },
            {
              "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": 1691.67
            },
            {
              "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": 626.6,
              "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": 626.6,
              "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": 2184.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 2635,
              "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": 2239.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1923.55
            },
            {
              "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": 614.07,
              "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": 620.21,
              "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": 644.77,
              "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": 2635,
              "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": 2635,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1691.67
            },
            {
              "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": 1665.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 644.77,
              "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": 620.21,
              "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": 2239.75
            },
            {
              "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": 644.77,
              "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": 2635,
              "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": 1923.55
            },
            {
              "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": 1691.67
            },
            {
              "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": 1715.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2160.7
            },
            {
              "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": 1665.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2635,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1665.32
            },
            {
              "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": 2635,
              "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": 2239.75
            },
            {
              "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": 2318.8
            },
            {
              "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": 614.07,
              "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": 63.2,
              "estimated_amount": 1665.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1449.25
            },
            {
              "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": 2635,
              "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": 614.07,
              "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": 2310.9
            },
            {
              "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": 1691.67
            },
            {
              "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": 2131.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 2184.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1976.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1665.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 2239.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1715.39
            },
            {
              "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": 2160.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1691.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1449.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1923.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2160.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 2184.42
            },
            {
              "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": 1691.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2160.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2239.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1449.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1923.55
            },
            {
              "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": 620.21,
              "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": 2635,
              "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": 2239.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2239.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 2635
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 2635
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1665.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1691.67
            },
            {
              "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": 2160.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2239.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1976.25
            },
            {
              "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": 2239.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1715.39
            },
            {
              "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": 1715.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2160.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2635,
              "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": 2635,
              "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": 2635,
              "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": 620.21,
              "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": 2239.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2239.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1923.55
            }
          ]
        }
      ]
    },
    {
      "description": "HC Biopsy Pancreas Perc Needle",
      "code_information": [
        {
          "code": "PX-36100410",
          "type": "CDM"
        },
        {
          "code": "48102",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4904,
          "discounted_cash": 3187.6,
          "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": 3148.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3579.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3099.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 4904,
              "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": 4168.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2697.2
            },
            {
              "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": 3148.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3678
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 4168.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3148.37
            },
            {
              "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": 4021.28
            },
            {
              "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": 4300.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4168.4
            },
            {
              "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": 2697.2
            },
            {
              "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": 4904,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4021.28
            },
            {
              "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": 3099.33
            },
            {
              "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": 4904,
              "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": 4904,
              "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": 3099.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2697.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 3187.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3148.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4021.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4168.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2697.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3579.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2697.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4168.4
            },
            {
              "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": 3148.37
            },
            {
              "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": 3192.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4065.42
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4904,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3678
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3099.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 4904,
              "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": 3579.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 4904,
              "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": 4021.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 4904,
              "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": 4168.4
            },
            {
              "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": 4904,
              "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": 4168.4
            },
            {
              "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": 3967.34
            },
            {
              "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": 3192.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2697.2
            },
            {
              "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": 3148.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3099.33
            },
            {
              "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": 3148.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2697.2
            },
            {
              "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": 4021.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4168.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3579.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4021.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4168.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3099.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3192.5
            },
            {
              "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": 4168.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 3148.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3148.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3967.34
            },
            {
              "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": 4065.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 3579.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3192.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3678
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 3099.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 4065.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4021.28
            },
            {
              "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": 3099.33
            },
            {
              "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": 4300.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4168.4
            },
            {
              "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": 3148.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3148.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3192.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3579.92
            },
            {
              "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": 1338.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4904,
              "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": 4315.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3148.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4021.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4168.4
            },
            {
              "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": 4904,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Insert Tunneled Intraperitoneal Cath Open",
      "code_information": [
        {
          "code": "PX-36100427",
          "type": "CDM"
        },
        {
          "code": "49421",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16118,
          "discounted_cash": 10476.7,
          "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": 10347.76
            },
            {
              "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": 10347.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13216.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10186.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 10347.76
            },
            {
              "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": 13700.3
            },
            {
              "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": 10347.76
            },
            {
              "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": 13700.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10347.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10186.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13700.3
            },
            {
              "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": 10492.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10492.82
            },
            {
              "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": 13039.46
            },
            {
              "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": 14183.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16118,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13216.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 11766.14
            },
            {
              "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": 10347.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 16118,
              "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": 13700.3
            },
            {
              "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": 13361.82
            },
            {
              "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": 16118,
              "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": 13700.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 13216.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 14135.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 8864.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8864.9
            },
            {
              "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": 13216.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10186.58
            },
            {
              "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": 10186.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 10476.7
            },
            {
              "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": 14135.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 16118,
              "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": 13216.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10347.76
            },
            {
              "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": 10347.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13216.76
            },
            {
              "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": 16118,
              "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": 13361.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 10347.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10347.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13039.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12088.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11766.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10186.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 13700.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13216.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13700.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13700.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 10492.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8864.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13700.3
            },
            {
              "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": 10492.82
            },
            {
              "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": 4400.21
            },
            {
              "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": 10186.58
            },
            {
              "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": 16118,
              "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": 8864.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13700.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12088.5
            },
            {
              "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": 8864.9
            },
            {
              "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": 16118,
              "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": 10347.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12088.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10347.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10186.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 10186.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 11766.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11766.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13361.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13216.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8864.9
            },
            {
              "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": 16118,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10492.82
            },
            {
              "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": 11766.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13700.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13700.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16118,
              "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": 8864.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11766.14
            }
          ]
        }
      ]
    },
    {
      "description": "HC Blln Dilat Intracran Vasospasm Addl Ves Diff Vas Territory",
      "code_information": [
        {
          "code": "PX-36100512",
          "type": "CDM"
        },
        {
          "code": "61642",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18836,
          "discounted_cash": 12243.4,
          "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": 12092.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12092.71
            },
            {
              "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": 15445.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 18836,
              "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": 15445.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16010.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16010.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16010.6
            },
            {
              "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": 18836,
              "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": 18836,
              "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": 10359.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15445.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 16010.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15615.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11904.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 10359.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13750.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12092.71
            },
            {
              "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": 18836,
              "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": 16519.17
            },
            {
              "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": 11904.35
            },
            {
              "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": 12092.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12092.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 11904.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12092.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11904.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12092.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12262.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15445.52
            },
            {
              "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": 12092.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12092.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15445.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 16010.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16010.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14127
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10359.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13750.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13750.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16010.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 14127
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13750.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 12262.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 16575.68
            },
            {
              "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": 15238.32
            },
            {
              "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": 10359.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10359.8
            },
            {
              "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": 16010.6
            },
            {
              "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": 11904.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16010.6
            },
            {
              "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": 12092.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18836,
              "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": 10359.8
            },
            {
              "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": 12092.71
            },
            {
              "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": 12092.71
            },
            {
              "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": 12262.24
            },
            {
              "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": 15445.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 18836,
              "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": 16010.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 15445.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13750.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14127
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 15615.04
            },
            {
              "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": 15445.52
            },
            {
              "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": 5142.23
            },
            {
              "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": 18836,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 18836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15238.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10359.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11904.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16010.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15615.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 16010.6
            },
            {
              "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": 12262.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13750.28
            },
            {
              "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": 18836,
              "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": 12243.4
            },
            {
              "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": 11904.35
            },
            {
              "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": 16519.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18836,
              "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": 11904.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12262.24
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection for Discogram Lumbar",
      "code_information": [
        {
          "code": "PX-36100525",
          "type": "CDM"
        },
        {
          "code": "62290",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4556,
          "discounted_cash": 2961.4,
          "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": 2924.95
            },
            {
              "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": 2924.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2924.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3685.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "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": 3995.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3776.92
            },
            {
              "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": 3872.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 4556,
              "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": 4556,
              "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": 2924.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2505.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2505.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3325.88
            },
            {
              "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": 3735.92
            },
            {
              "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": 3872.6
            },
            {
              "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": 2924.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 2965.96
            },
            {
              "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": 4556,
              "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": 3325.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "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": 2879.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "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": 4556,
              "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": 2924.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2505.8
            },
            {
              "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": 2879.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2924.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "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": 3735.92
            },
            {
              "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": 1243.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 3872.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2965.96
            },
            {
              "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": 4556,
              "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": 2505.8
            },
            {
              "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": 3325.88
            },
            {
              "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": 4556,
              "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": 3776.92
            },
            {
              "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": 2965.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2924.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3995.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2879.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 4556,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "estimated_amount": 140
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3417
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3325.88
            },
            {
              "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": 4556,
              "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": 4556,
              "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": 3735.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 2879.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4556,
              "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": 2961.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2505.8
            },
            {
              "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": 4556,
              "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": 4556,
              "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": 2924.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3735.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 4556,
              "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": 4556,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 4556,
              "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": 2505.8
            },
            {
              "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": 4556,
              "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": 3872.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "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": 4556,
              "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": 2505.8
            },
            {
              "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": 4556,
              "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": 3685.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2879.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4556,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2879.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 2924.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2924.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 4556,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 3735.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3735.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3417
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2965.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3735.92
            },
            {
              "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": 4556,
              "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": 3872.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2879.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            },
            {
              "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": 4556,
              "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": 2965.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3325.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3325.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "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": 4556,
              "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": 4009.28
            },
            {
              "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": 4556,
              "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": 4556,
              "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": 3417
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4556,
              "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": 2924.95
            },
            {
              "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": 3735.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2879.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4556,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3776.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3872.6
            }
          ]
        }
      ]
    },
    {
      "description": "Injection Anes/Steroid Sciatic Nerve Single",
      "code_information": [
        {
          "code": "PX-36100551",
          "type": "CDM"
        },
        {
          "code": "64445",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7976,
          "discounted_cash": 5184.4,
          "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": 5120.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5822.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6612.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6779.6
            },
            {
              "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": 5120.59
            },
            {
              "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": 6452.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6452.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6540.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7976,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5120.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6779.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6540.32
            },
            {
              "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": 5040.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 2177.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6779.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5822.48
            },
            {
              "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": 5120.59
            },
            {
              "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": 5040.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5040.83
            },
            {
              "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": 7018.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5120.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 6779.6
            },
            {
              "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": 6612.1
            },
            {
              "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": 6779.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5040.83
            },
            {
              "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": 5822.48
            },
            {
              "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": 7976,
              "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": 7976,
              "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": 5120.59
            },
            {
              "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": 7976,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6994.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 7976,
              "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": 7976,
              "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": 7976,
              "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": 7976,
              "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": 6540.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6540.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 6779.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4386.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5822.48
            },
            {
              "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": 6540.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4386.8
            },
            {
              "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": 5040.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 5192.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6779.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 5120.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4386.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5040.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6779.6
            },
            {
              "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": 5184.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6779.6
            },
            {
              "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": 5120.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4386.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5192.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5982
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5822.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 7976,
              "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": 5120.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6540.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5120.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6540.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5120.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5982
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6994.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 6540.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5982
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5040.83
            },
            {
              "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": 4386.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 4386.8
            },
            {
              "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": 7976,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5120.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5192.38
            },
            {
              "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": 5192.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6779.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5822.48
            },
            {
              "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": 6779.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5192.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4386.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5040.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7976,
              "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": 6779.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6612.1
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection Anes Stellate Ganglion",
      "code_information": [
        {
          "code": "PX-36100567",
          "type": "CDM"
        },
        {
          "code": "64510",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7432,
          "discounted_cash": 4830.8,
          "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": 4771.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 811.76,
              "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": 7432,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 811.76,
              "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": 5425.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 7432,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 1627.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5425.36
            },
            {
              "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": 7432,
              "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": 4771.34
            },
            {
              "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": 4771.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 803.48,
              "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": 6317.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4771.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5425.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4771.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6094.24
            },
            {
              "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": 6012.49
            },
            {
              "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": 6094.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 7432,
              "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": 7432,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 4087.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4771.34
            },
            {
              "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": 795.53,
              "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": 6094.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6317.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4087.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 6317.2
            },
            {
              "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": 795.53,
              "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": 835.3,
              "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": 7432,
              "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": 4087.6
            },
            {
              "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": 6317.2
            },
            {
              "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": 795.53,
              "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": 6094.24
            },
            {
              "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": 4771.34
            },
            {
              "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": 811.76,
              "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": 4830.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5574
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4697.02
            },
            {
              "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": 7432,
              "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": 4697.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 4697.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4697.02
            },
            {
              "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": 835.3,
              "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": 6317.2
            },
            {
              "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": 4838.23
            },
            {
              "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": 803.48,
              "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": 5574
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4771.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6094.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6317.2
            },
            {
              "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": 6517.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 7432,
              "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": 6012.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4838.23
            },
            {
              "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": 2028.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5425.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6317.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6161.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6317.2
            },
            {
              "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": 4771.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 795.53,
              "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": 4087.6
            },
            {
              "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": 4771.34
            },
            {
              "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": 6517.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 6317.2
            },
            {
              "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": 7432,
              "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": 7432,
              "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": 4771.34
            },
            {
              "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": 4087.6
            },
            {
              "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": 803.48,
              "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": 4087.6
            },
            {
              "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": 835.3,
              "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": 4087.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4697.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 6317.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6094.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5574
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4771.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6094.24
            },
            {
              "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": 6094.24
            },
            {
              "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": 6540.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4697.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 6317.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6317.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5425.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4838.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6161.13
            },
            {
              "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": 803.48,
              "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": 6317.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5425.36
            },
            {
              "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": 803.48,
              "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": 4838.23
            },
            {
              "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": 4838.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7432,
              "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": 4697.02
            },
            {
              "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": 4697.02
            },
            {
              "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": 6161.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6317.2
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mod Sed Other Provider Than Proc Addl 15 Min",
      "code_information": [
        {
          "code": "PX-37000008",
          "type": "CDM"
        },
        {
          "code": "99157",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 599,
          "discounted_cash": 389.35,
          "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": 384.56
            },
            {
              "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": "MMO MANAGED MEDICARE [486]",
              "plan_name": "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "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": "UHC 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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 449.25
            },
            {
              "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": 509.15
            },
            {
              "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "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": 437.27
            },
            {
              "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": 599,
              "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": 329.45
            },
            {
              "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": 599,
              "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": 509.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "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": "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": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 525.32
            },
            {
              "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 389.95
            },
            {
              "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": 163.53
            },
            {
              "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": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "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": "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": "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": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA 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": "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": "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": "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": "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": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "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": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "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": "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": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "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": "HUMANA [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": "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": "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": "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": "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": "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 TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "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": 389.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "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 [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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "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": 599,
              "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": 599,
              "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": 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 OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "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": 599,
              "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": 449.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "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": 484.59
            },
            {
              "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": 332.45
            },
            {
              "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": 599,
              "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": 509.15
            },
            {
              "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": 384.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "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": 599,
              "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": 496.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "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": 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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "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 PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "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": 599,
              "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": 599
            },
            {
              "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": "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "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": "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": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE 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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "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": 599,
              "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": 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": "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": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "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": "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": "BUCKEYE COMMUNITY 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": "AETNA [310]",
              "plan_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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "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": "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": "CARESOURCE MANAGED MEDICARE [254]",
              "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"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter External Latex Intermediate 32mm Standard Wr",
      "code_information": [
        {
          "code": "PX-CH-HO9609",
          "type": "CDM"
        },
        {
          "code": "A4349",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.91,
          "discounted_cash": 1.24,
          "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": 1.23
            },
            {
              "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": 1.57
            },
            {
              "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": 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": 1.21
            },
            {
              "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": 1.68
            },
            {
              "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": 1.23
            },
            {
              "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": 1.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "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": 1.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 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": 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": 1.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "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": 1.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.58
            },
            {
              "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": 1.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 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": 1.23
            },
            {
              "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": 1.23
            },
            {
              "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": 1.21
            },
            {
              "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": 1.91,
              "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": 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": 1.23
            },
            {
              "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": 1.23
            },
            {
              "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": 0.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.91,
              "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": 1.43
            },
            {
              "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": 1.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "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": 1.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.21
            },
            {
              "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": 1.91,
              "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": 1.91,
              "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": 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": 1.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.91,
              "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": 1.57
            },
            {
              "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": 1.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.91,
              "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": 1.91,
              "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": 1.62
            },
            {
              "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": 1.06
            },
            {
              "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": 1.62
            },
            {
              "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": 1.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 1.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "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": 1.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 1.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.91,
              "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": 1.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.62
            },
            {
              "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": 1.24
            },
            {
              "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": 1.91,
              "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": 1.91,
              "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": 1.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "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": 1.23
            },
            {
              "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": 1.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.91,
              "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": 1.21
            }
          ]
        }
      ]
    },
    {
      "description": "Island Composite Drsg Adhesive Telfa 2 in X 3 1/2 In",
      "code_information": [
        {
          "code": "PX-CH-KN7539",
          "type": "CDM"
        },
        {
          "code": "A6219",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.23,
          "discounted_cash": 0.15,
          "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": 0.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "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": 0.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "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": 0.23,
              "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": 0.15
            },
            {
              "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": 0.19
            },
            {
              "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": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.23
            },
            {
              "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": 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": 0.15
            },
            {
              "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": 0.23,
              "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": 0.2
            },
            {
              "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": 0.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.23,
              "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": 0.23,
              "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": 0.2
            },
            {
              "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "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": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.23,
              "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": 0.17
            },
            {
              "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": 0.23,
              "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": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.19
            },
            {
              "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": "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": "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": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.23,
              "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": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.15
            },
            {
              "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": 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": 0.15
            },
            {
              "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": 0.23,
              "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": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.23,
              "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": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.17
            },
            {
              "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": 0.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.2
            },
            {
              "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": 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": 0.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.23,
              "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": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.19
            },
            {
              "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.15
            },
            {
              "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": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.23,
              "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": 0.23,
              "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": 0.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": 0.17
            },
            {
              "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": 0.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.23,
              "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": 0.23,
              "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": 0.17
            },
            {
              "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": 0.23,
              "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": 0.15
            },
            {
              "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": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.19
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "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": 0.17
            },
            {
              "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": 0.23,
              "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": 0.23,
              "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": 0.23,
              "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": 0.23,
              "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": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.2
            },
            {
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 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": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.23,
              "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": 0.17
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.23,
              "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": 0.15
            },
            {
              "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": 0.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "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": 0.23,
              "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": 0.2
            },
            {
              "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": 0.23,
              "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": 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": 0.23,
              "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": 0.23,
              "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": 0.15
            },
            {
              "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": 0.23,
              "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": 0.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC US Fetal Biophysical Profile WO Nst",
      "code_information": [
        {
          "code": "PX-40200022",
          "type": "CDM"
        },
        {
          "code": "76819",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 370,
          "discounted_cash": 240.5,
          "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": 237.54
            },
            {
              "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": 237.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 270.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 370,
              "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": 370,
              "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": 233.84
            },
            {
              "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": 233.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 370,
              "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": 325.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 240.87
            },
            {
              "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": 205.35
            },
            {
              "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": 101.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 370,
              "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": 370,
              "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": 370,
              "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": 324.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 237.54
            },
            {
              "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": 303.4
            },
            {
              "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": 303.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 233.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 203.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 270.1
            },
            {
              "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": 95.95,
              "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": 277.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 277.5
            },
            {
              "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": 370,
              "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": 370,
              "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": 370,
              "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": 95.95,
              "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": 303.4
            },
            {
              "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": 314.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 203.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 203.5
            },
            {
              "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": 370,
              "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": 370,
              "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": 314.5
            },
            {
              "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": 306.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "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": 203.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 237.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 370,
              "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": 270.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "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": 97.91,
              "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": 314.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 270.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 270.1
            },
            {
              "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": 96.91,
              "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": 237.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 303.4
            },
            {
              "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": 205.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 306.73
            },
            {
              "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": 370,
              "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": 299.33
            },
            {
              "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": 303.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 303.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 233.84
            },
            {
              "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": 100.75,
              "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": 237.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 237.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 303.4
            },
            {
              "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": 96.91,
              "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": 97.91,
              "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": 370
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 237.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 240.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 233.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 370,
              "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": 370,
              "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": 370,
              "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": 240.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 203.5
            },
            {
              "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": 314.5
            },
            {
              "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": 237.54
            },
            {
              "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": 95.95,
              "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": 63.2,
              "estimated_amount": 233.84
            },
            {
              "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": 240.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 303.4
            },
            {
              "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": 100.75,
              "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": 240.87
            },
            {
              "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": 240.5
            },
            {
              "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": 370,
              "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": 237.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 299.33
            },
            {
              "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": 370,
              "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": 270.1
            },
            {
              "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": 233.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 370,
              "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": 205.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 203.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 370,
              "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": 97.91,
              "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": 370,
              "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": 237.54
            },
            {
              "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": 205.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 314.5
            },
            {
              "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": 324.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 370,
              "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": 100.75,
              "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": 96.91,
              "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": 306.73
            },
            {
              "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": 96.91,
              "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": 370,
              "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": 314.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 203.5
            },
            {
              "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": 95.95,
              "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": 233.84
            },
            {
              "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": 96.91,
              "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": 237.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 277.5
            }
          ]
        }
      ]
    },
    {
      "description": "Moisture Barrier Ointment Aloe Vesta 8 Oz",
      "code_information": [
        {
          "code": "PX-CH-CV4018-99",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14.4,
          "discounted_cash": 9.36,
          "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": 9.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "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": "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": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "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": 12.24
            },
            {
              "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": "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": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "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": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "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": 14.4,
              "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": 7.99
            },
            {
              "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": "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": "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": "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": "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": "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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "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": "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": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14.4,
              "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": 14.4,
              "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": 11.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 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": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "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": 11.81
            },
            {
              "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": "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": "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": "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 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": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "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": 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 OXFORD [625260]",
              "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 MEIJER STEPS2HEALTH [555210]",
              "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": "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": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.65
            },
            {
              "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": 14.4,
              "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": 11.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "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": 12.63
            },
            {
              "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": "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": "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": "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": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.37
            },
            {
              "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": 11.81
            },
            {
              "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": "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 MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14.4,
              "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": 12.24
            },
            {
              "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": "AETNA [310]",
              "plan_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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "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": "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": "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": "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": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "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": 14.4,
              "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": 7.92
            },
            {
              "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": 12.63
            },
            {
              "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": "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": "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": "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": "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": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "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 BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.94
            },
            {
              "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": "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": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "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": 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 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": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 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": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "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": 14.4,
              "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": 7.99
            },
            {
              "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": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "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": 3.93
            },
            {
              "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": "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": "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": "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": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.8
            }
          ]
        }
      ]
    },
    {
      "description": "Pt Electrical Stim Attended 15 Min",
      "code_information": [
        {
          "code": "PX-42000014",
          "type": "CDM"
        },
        {
          "code": "97032",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 203,
          "discounted_cash": 131.95,
          "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": 64.2,
              "estimated_amount": 130.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 111.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 152.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 128.3
            },
            {
              "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": 166.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 111.65
            },
            {
              "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": 111.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 128.3
            },
            {
              "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": 13.82
            },
            {
              "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": 178.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 203,
              "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": 130.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 111.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 111.65
            },
            {
              "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": 13.82
            },
            {
              "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": 14.51
            },
            {
              "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": 172.55
            },
            {
              "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": 18.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 203,
              "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": 203,
              "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": 172.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 172.55
            },
            {
              "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": 13.82
            },
            {
              "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": 128.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 112.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 112.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 111.65
            },
            {
              "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": 148.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 148.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 130.33
            },
            {
              "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": 172.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 203
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 168.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 128.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 132.15
            },
            {
              "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": 132.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 152.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 130.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 13.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 132.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 203,
              "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": 172.55
            },
            {
              "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": 131.95
            },
            {
              "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": 203,
              "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": 130.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 166.46
            },
            {
              "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": 13.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 172.55
            },
            {
              "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": 112.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 152.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 166.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 166.46
            },
            {
              "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": 132.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 128.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 13.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 111.65
            },
            {
              "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": 203,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 13.82
            },
            {
              "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": 128.3
            },
            {
              "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": 203,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "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": 13.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 168.29
            },
            {
              "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": 203,
              "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": 178.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 172.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.19
            },
            {
              "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": 13.82
            },
            {
              "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": 55.42
            },
            {
              "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": 130.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 128.3
            },
            {
              "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": 13.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 172.55
            },
            {
              "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": 112.67
            },
            {
              "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": 130.33
            },
            {
              "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": 164.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 172.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 168.29
            },
            {
              "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": 166.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 172.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 130.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 132.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 166.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 148.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 172.55
            },
            {
              "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": 178.03
            },
            {
              "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": 128.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 130.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 166.46
            },
            {
              "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": 203,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 13.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 172.55
            },
            {
              "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": 130.33
            },
            {
              "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": 203,
              "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": 166.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 130.33
            },
            {
              "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": 13.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 172.55
            },
            {
              "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": 13.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 203,
              "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": 164.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 203,
              "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": 172.55
            },
            {
              "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": 130.33
            }
          ]
        }
      ]
    },
    {
      "description": "HC Application Cast Long Arm",
      "code_information": [
        {
          "code": "PX-43000001",
          "type": "CDM"
        },
        {
          "code": "29065",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 425,
          "discounted_cash": 276.25,
          "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": 64.2,
              "estimated_amount": 272.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 343.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 235.88
            },
            {
              "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": 425,
              "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": 361.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 272.85
            },
            {
              "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": 233.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 310.25
            },
            {
              "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": 272.85
            },
            {
              "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": 235.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 318.75
            },
            {
              "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": 276.68
            },
            {
              "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": 343.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 348.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 425,
              "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": 425,
              "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": 272.85
            },
            {
              "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": 348.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "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": 352.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 425,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 348.5
            },
            {
              "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": 374
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 425,
              "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": 425,
              "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": 233.75
            },
            {
              "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": 272.85
            },
            {
              "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": 276.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 348.5
            },
            {
              "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": 268.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 425
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 425,
              "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": 272.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 276.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 425,
              "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": 235.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 272.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 425,
              "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": 361.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 276.68
            },
            {
              "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": 348.5
            },
            {
              "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": 425,
              "additional_payer_notes": " ASC LISTED"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 372.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "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": 310.25
            },
            {
              "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": 425,
              "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": 425,
              "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": 310.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 310.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 272.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 352.33
            },
            {
              "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": 276.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 233.75
            },
            {
              "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": 235.88
            },
            {
              "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": 116.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 268.6
            },
            {
              "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": 268.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 310.25
            },
            {
              "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": 372.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 272.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 348.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 310.25
            },
            {
              "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": 268.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 348.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 425,
              "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": 348.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 352.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 233.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 272.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 233.75
            },
            {
              "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": 425,
              "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": 272.85
            },
            {
              "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": 272.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 276.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 268.6
            },
            {
              "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": 361.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 318.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 361.25
            }
          ]
        }
      ]
    },
    {
      "description": "HC St Ped Treat Complex",
      "code_information": [
        {
          "code": "PX-44000003",
          "type": "CDM"
        },
        {
          "code": "92507",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 416,
          "discounted_cash": 270.4,
          "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": 267.07
            },
            {
              "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": 113.57
            },
            {
              "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": 77.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 262.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 267.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 416,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "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": 73.42
            },
            {
              "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": 267.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 270.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 230.88
            },
            {
              "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": 344.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 267.07
            },
            {
              "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": 416,
              "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": 353.6
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 416,
              "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": 353.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 228.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 228.8
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 336.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 262.91
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "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": 262.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 270.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 303.68
            },
            {
              "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": 353.6
            },
            {
              "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": 73.42
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "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": 336.54
            },
            {
              "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": 230.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 416
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 228.8
            },
            {
              "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": 230.88
            },
            {
              "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": 416,
              "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": 416,
              "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": 270.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 228.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 416,
              "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": 416,
              "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": 270.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 312
            },
            {
              "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": 73.42
            },
            {
              "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": 303.68
            },
            {
              "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": 73.42
            },
            {
              "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": 416,
              "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": 262.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 341.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 341.12
            },
            {
              "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": 341.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 228.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 267.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 341.12
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 228.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 303.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 312
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "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": 230.88
            },
            {
              "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": 353.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "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": 416,
              "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": 416,
              "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": 416,
              "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": 366.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 267.07
            },
            {
              "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": 267.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 267.07
            },
            {
              "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": 270.82
            },
            {
              "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": 364.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 267.07
            },
            {
              "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": 228.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 341.12
            },
            {
              "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": 73.42
            },
            {
              "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": 78.21
            },
            {
              "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": 341.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 341.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 353.6
            },
            {
              "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": 262.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 303.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 344.86
            },
            {
              "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": 364.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 262.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 270.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 341.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 416,
              "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": 416,
              "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": 267.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 262.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 303.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 303.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 267.07
            },
            {
              "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": 73.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 267.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 344.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 262.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 416,
              "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": 312
            }
          ]
        }
      ]
    },
    {
      "description": "HC ER Level IV",
      "code_information": [
        {
          "code": "PX-45000036",
          "type": "CDM"
        },
        {
          "code": "99284",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2770,
          "discounted_cash": 1800.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2271.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2027.64
            },
            {
              "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": 2429.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2077.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.8,
              "estimated_amount": 2293.56
            },
            {
              "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": 394.45,
              "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": 2271.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2022.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2027.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2271.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2022.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2240.93
            },
            {
              "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": 386.56,
              "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": 2022.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "case rate",
              "standard_charge_dollar": 260,
              "estimated_amount": 260
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2271.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2271.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "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": 2022.1
            },
            {
              "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": 390.43,
              "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": 2437.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "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": 386.56,
              "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": 73.2,
              "estimated_amount": 2027.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1803.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1523.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1523.5
            },
            {
              "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": 390.43,
              "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": 2354.5
            },
            {
              "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": 390.43,
              "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": 2770,
              "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": 73.5,
              "estimated_amount": 2035.95
            },
            {
              "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": 2429.29
            },
            {
              "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": 2027.64
            },
            {
              "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": 1800.5
            },
            {
              "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": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "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": 405.89,
              "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": 1803.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1803.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2296.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2022.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "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": 1523.5
            },
            {
              "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": 2038.72
            },
            {
              "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": 386.56,
              "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": 2296.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.8,
              "estimated_amount": 2293.56
            },
            {
              "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": 394.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1523.5
            },
            {
              "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": 386.56,
              "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": 2770,
              "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": 73.2,
              "estimated_amount": 2027.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "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": 2038.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "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": 1803.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "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": 2354.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 2038.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1523.5
            },
            {
              "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": 2035.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1523.5
            },
            {
              "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": 2354.5
            },
            {
              "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": 2038.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2271.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2354.5
            },
            {
              "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": 756.21
            },
            {
              "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": 2038.72
            },
            {
              "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": 2027.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 79.3,
              "estimated_amount": 2196.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2022.1
            },
            {
              "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": 2296.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 2027.64
            },
            {
              "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": 405.89,
              "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": 1803.27
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 394.45,
              "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": 386.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 2035.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "case rate",
              "standard_charge_dollar": 260,
              "estimated_amount": 260
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "per